How much should systolic blood pressure rise during a normal ETT?

During a normal exercise tolerance test (ETT), it is generally expected that the systolic blood pressure will rise by 20 mmHg or more. This increase signifies an appropriate cardiovascular response to physical exertion, indicating that the heart and blood vessels are functioning well under stress. When a person exercises, the heart needs to pump more blood to supply muscles with oxygen, leading to this expected rise in blood pressure. An increase of this magnitude ensures that there is sufficient blood flow to meet the increased metabolic demands of the body during exercise.

An increase lower than 20 mmHg, such as 10 mmHg or 15 mmHg, may not indicate adequate cardiovascular response and could potentially signal underlying health issues. Similarly, a rise of 30 mmHg or more could suggest an abnormal response, as excessively high increases might indicate stress on the cardiovascular system or pathological conditions. Therefore, the threshold of 20 mmHg serves as a benchmark for normal physiological response during exercise testing.