Blood pressure (BP) dynamics during graded exercise testing provide important insights into cardiovascular health, particularly in athletes. These measurements, taken during intense physical exertion, complement and often enhance our understanding beyond traditional resting BP measurements. Historically, the challenge has been to distinguish 'normal' from 'exaggerated' BP responses in the athletic environment. While basic guidelines have served their purpose, they may not fully account for the complex nature of BP responses in today's athletes, as illuminated by contemporary research. This review critically evaluates existing guidelines in the context of athletic performance and cardiovascular health. Through a rigorous analysis of the current literature, we highlight the multifaceted nature of exercise-induced BP fluctuations in athletes, emphasising the myriad determinants that influence these responses, from specific training regimens to inherent physiological nuances. Our aim is to advocate a tailored, athlete-centred approach to BP assessment during exercise. Such a paradigm shift is intended to set the stage for evidence-based guidelines to improve athletic training, performance and overall cardiovascular well-being.

Faculty of Medicine Masaryk University Kamenice 735 5 625 00 Brno Czech Republic

Faculty of Medicine Palacky University Krizkovskeho 511 8 779 00 Olomouc Czech Republic

Faculty of Medicine University of Ostrava Syllabova 19 703 00 Ostrava Czech Republic

Sports Cardiology Center Nemocnice Agel Trinec Podlesi Konska 453 739 61 Trinec Czech Republic

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