Cardiopulmonary Exam Skills Practice Test

During graded exercise, systolic blood pressure should rise as workload increases because the heart pumps more blood to meet the higher demands. When SBP does not rise adequately—or may even fall—with increasing effort, that pattern is described as a hypotensive response to exercise. This finding flags potential underlying heart disease, such as coronary artery disease or left ventricular dysfunction, because the heart cannot augment output or perfusion effectively during stress. It’s distinct from a hypertensive response, where SBP rises too high with exercise, and from post-exercise hypotension, which occurs after finishing activity. The idea here is that an inadequate SBP rise under load points to possible cardiac pathology that merits further evaluation.