Treadmill Testing in Hypertensives

To the Editor.—  Dr Fleg¹ answers some questions about resistive exercise in hypertensive persons. While he seems comfortable with the performance of such exercises by hypertensive patients with controlled resting blood pressures, I think the position he takes merits some scrutiny. Though it appears "safe" for adult hypertensives to engage in resistive exercises, it is likely that in many of them there is an escape from blood pressure control during such exercise.² Though this may represent no short-term risk, recurrent pressure elevations may be a factor in the long-term development of left ventricular hypertrophy. There is evidence that left ventricular hypertrophy correlates better with arterial pressure during normal activity and with exaggerated blood pressure responses to exercise.^3,4 Certainly the increased hazard of complications to hypertensive patients with left ventricular hypertrophy is well known.The diastolic blood pressure response to aerobic exercise in patients with borderline hypertension (eg