Increased blood pressure levels relative to subjective feelings of intensity of exercise determined with the Borg scale in male patients with hypertension

We examined the hemodynamic responses to exercise and symptoms in 37 male patients with untreated essential hypertension, and compared the findings with those in 32 age-matched healthy male volunteers by performing a graded symptom-limited exercise test using a bicycle ergometer. The subjective feeling of intensity of exercise was determined using the Borg scale. In the relationship between Borg scores and blood pressure (BP), patients with hypertension showed higher systolic BP and diastolic BP relative to the Borg scores than the controls. Consequently, patients with hypertension showed significantly higher systolic BP with Borg scores ≤ 3 (subjective symptoms ≤ moderately hard) than the controls (177.8 ± 27.0 vs. 143.7 ± 17.9 mmHg, p < 0.0001). Similarly, significantly higher diastolic BP with Borg scores ≤ 3 was observed in patients with hypertension than in the controls (101.6 ± 12.0 vs. 82.6 ± 11.6 mmHg, p < 0.0001). The pulse pressure with Borg scores ≤ 3 was also significantly higher in patients with hypertension than in the controls (76.2 ± 20.6 vs. 61.0 ± 13.6 mmHg, p < 0.0001). Hypertensive patients showed a decrease in the high-frequency power of heart rate variability at initial low-load exercise. In conclusion, the present study revealed that there was a greater BP response relative to the Borg score in patients with hypertension than in the controls. Autonomic nerve activity may contribute to some extent to these different relations. A determination of the relationship between the subjective feeling of intensity of the exercise and BP levels caused by a given intensity of load is essential before exercise training in patients, at least in males, with hypertension to avoid increasing the risk of cardiovascular events in association with excessive exercise training.