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| Author (year) | Study size (n) | Definition for HRE | Age (years) | Gender (% male) | Exercise testing protocol | Study design | Summary of findings |
|
| Chung et al. [16] | 797 | SBP ≥210 mmHg for male and ≥190 mmHg for female | 64 ± 10 | 62 | Symptom-limited supine bicycle testing; increase in workload of 25 W every 3 min | Cross-sectional | Subjects with HRE had higher LVMI and diastolic dysfunction. Arterial stiffness was related to HRE. Women had a higher prevalence of HRE |
| Kayrak et al. [17] | 61 | SBP ≥210 mmHg for male and ≥190 mmHg for female | 47.5 ± 9.7 | 77 | Bruce protocol | Cross-sectional | Masked hypertension prevalence is higher in patients with HRE and is related to higher BMI, adverse lipid profile, higher DBP during exercise and nocturnal DBP fall |
| Sharman et al. [18] | 72 | SBP ≥210 mmHg for male and ≥190 mmHg for female or DBP ≥105 mmHg in both | 54 ± 9 | 60 | Bruce protocol | Cross-sectional | Masked hypertension can be identified with 24 h ABPM and is highly prevalent in patients with HRE |
| Schultz et al. [19] | 75 | SBP ≥210 mmHg for male and ≥190 mmHg for female | 54 ± 9 | 52 | Cycle ergometer steady state heart rate at 60–70% of age-predicted maximal heart rate | Cross-sectional | 56% of subjects with HRE had masked hypertension. During low-intensity exercise, brachial BP measurements were increased in subjects with MH. Light exercise BP predicts the presence of MH with high specificity |
| Schultz et al. [20] | 100 | SBP ≥150 mmHg at stage one of the test | 56 ± 9 | 72 | Bruce protocol | Cross-sectional | SBP ≥150 mmHg during early stages of exercise stress testing is associated with hypertension as identified through 24 hour ABPM |
| Takamura et al. [21] | 129 | SBP/DBP ≥210/105 mmHg in males, and ≥190/105 mmHg in females | 63 ± 9 | 64 | Bruce protocol | Cross-sectional | Subjects with HRE had an impaired LV diastolic function and exercise intolerance |
| Yang et al. [22] | 171 | SBP ≥200 mmHg for male and ≥190 mmHg for female | 48 ± 8 | 56.7 | Bruce protocol | Cross-sectional | Conventional echocardiographic examination showed no differences in LVMI or ejection fraction. Analysis with speckle tracking imaging demonstrated that individuals with HRE had impaired myocardial function |
| Berger et al. [23] | 7082 | Definition according to the values at peak exercise | 48 ± 9 | 73 | Bruce protocol | Prospective (5 ± 3 years) | 14.6% developed new-onset hypertension |
| Farah et al. [24] | 30 | SBP ≥200 mmHg or DBP ≥100 mmHg | 45 ± 10 | 53 | Bruce protocol | Prospective (2 years) | 84% of subjects with HRE developed hypertension during the following 2 years |
| Hietanen et al. [25] | 3808 | ≥215 mmHg | 50 | 66 | Symptom-limited bicycle testing; increase in workload of 40–50 W every 3 min | Prospective (15 years) | In persons with normal resting blood pressure, elevated ankle blood pressure in combination with HRE, was a significant independent predictor for coronary heart disease |
| Ito et al. [26] | 733 | SBP ≥200 mmHg | 41 ± 5 | 100 | Stepwise graded exercise test protocol consisting of three grades—ergometer | Prospective (10 years) | HRE was positive correlated to hypertension at rest |
| Kjeldsen et al. [27] | 1999 | SBP ≥200 mmHg | 40–59 | 100 | Symptom-limited bicycle testing; increase in workload of 50 W every 6 min | Prospective (21 years) | Higher SBP values during moderate effort were related to CV mortality. The maximal SBP during exercise didn’t show an influence on CV death |
| Kurl et al. [28] | 1026 | No definition | 52.5 ± 4.7 | 100 | Symptom-limited bicycle testing; increase in the workload of 20 W/min | Prospective (10.4 years) | A high SBP rise per minute of exercise was independently associated with an increased risk of stroke |
| Laukkanen et al. [29] | 1731 | No definition | 52.3 ± 5.3 | 100 | Symptom-limited bicycle testing; increase in the workload of 20 W/min | Prospective (12.7 years) | An exaggerated rise in SBP during exercise was related to an increased risk of acute myocardial infarction |
| Lewis et al. [9] | 3045 | No definition | 43 | 47 | Bruce protocol | Prospective (20 years) | HRE was associated with adverse cardiovascular events |
| Miyai et al. [30] | 239 | No definition | 42.3 ± 5.9 | 100 | Symptom-limited bicycle testing; a linear-slope method at a rate of 12.5 W × min−1 was used to increase workload | Prospective (5.1 years) | HRE and high-normal BP represent a risk factor for the development of hypertension |
| Weiss et al. [31] | 6578 | Bruce stage 2 SBP ≥180 mmHg | 46 | 55 | Bruce protocol | Prospective (20.1 ± 4 years) | Elevated BP at rest, at low-level exercise, and at maximal exercise were all associated with CVD death independently from non-BP risk factors |
| Yzaguirre et al. [32] | 107 | SBP/DBP ≥215/95 mmHg at maximum, SBP/DBP ≥180/90 mmHg at moderate exercise | 25.7 ± 11.1 | 72 | Symptom-limited bicycle testing; increase in the workload of 25 W/min | Prospective (20 years) | Subjects presenting DBP over 95 mmHg at peak exercise or SBP >180 mmHg during moderate exercise had a 70% risk of developing hypertension |
| Mottram et al. [33] | 58 | SBP/DBP ≥210/105 mmHg in male, SBP/DBP ≥190/105 mmHg in female | 56 ± 10 | 42 | Bruce protocol | Case-control | In patients without resting hypertension, HRE is associated with slight systolic dysfunction |
| Sharabi et al. [34] | 190 | SBP/DBP ≥200/100 mmHg | 42.6 | 100 | Bruce protocol | Case-control | The risk of developing hypertension was higher in subjects with HRE than in the control group |
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