The clinical value of an exaggerated hypertensive response to exercise

Sobrino, J.; Domenech, M.

doi:10.1016/j.rceng.2017.09.005

array:25 ["pii" => "S2254887417301297" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.09.005" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1440" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Clin Esp. 2018;218:13-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0014256517302321" "issn" => "00142565" "doi" => "10.1016/j.rce.2017.09.006" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1440" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Clin Esp. 2018;218:13-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 72 "formatos" => array:2 [ "HTML" => 53 "PDF" => 19 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "Editorial" "titulo" => "El valor clínico de la respuesta hipertensiva exagerada al ejercicio" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "14" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The clinical value of an exaggerated hypertensive response to exercise" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Sobrino, M. Domenech" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Sobrino" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Domenech" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2254887417301297" "doi" => "10.1016/j.rceng.2017.09.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301297?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517302321?idApp=WRCEE" "url" => "/00142565/0000021800000001/v1_201801070655/S0014256517302321/v1_201801070655/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S225488741730139X" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.10.008" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1448" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Clin Esp. 2018;218:15-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "formatos" => array:2 [ "HTML" => 1 "PDF" => 1 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Editorial" "titulo" => "The clinician and their patient at the end of life" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "15" "paginaFinal" => "16" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El médico clínico ante el paciente en el final de sus días" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Conthe" "autores" => array:1 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Conthe" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S001425651730259X" "doi" => "10.1016/j.rce.2017.10.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S001425651730259X?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741730139X?idApp=WRCEE" "url" => "/22548874/0000021800000001/v1_201801040959/S225488741730139X/v1_201801040959/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2254887417301029" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.07.001" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1420" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2018;218:7-12" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Exaggerated hypertensive response to exercise and myocardial ischemia in patients with known or suspected coronary artery disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "12" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta hipertensiva exagerada al ejercicio e isquemia miocárdica en pacientes con enfermedad coronaria conocida o sospechada" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Bouzas-Mosquera, A. Bouzas-Mosquera, J. Peteiro" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Bouzas-Mosquera" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Bouzas-Mosquera" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Peteiro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256517301790" "doi" => "10.1016/j.rce.2017.07.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517301790?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301029?idApp=WRCEE" "url" => "/22548874/0000021800000001/v1_201801040959/S2254887417301029/v1_201801040959/en/main.assets" ] "asociados" => array:1 [ 0 => array:19 [ "pii" => "S2254887417301029" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.07.001" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "1420" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2018;218:7-12" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Exaggerated hypertensive response to exercise and myocardial ischemia in patients with known or suspected coronary artery disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "12" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta hipertensiva exagerada al ejercicio e isquemia miocárdica en pacientes con enfermedad coronaria conocida o sospechada" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Bouzas-Mosquera, A. Bouzas-Mosquera, J. Peteiro" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Bouzas-Mosquera" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Bouzas-Mosquera" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Peteiro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256517301790" "doi" => "10.1016/j.rce.2017.07.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517301790?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301029?idApp=WRCEE" "url" => "/22548874/0000021800000001/v1_201801040959/S2254887417301029/v1_201801040959/en/main.assets" ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Editorial" "titulo" => "The clinical value of an exaggerated hypertensive response to exercise" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "14" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Sobrino, M. Domenech" "autores" => array:2 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Sobrino" "email" => array:1 [ 0 => "jsobrino@hes.scs.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Domenech" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de HTA, Servicio de Medicina Interna, Fundació Hospital de l’Esperit Sant, Universitat de Barcelona, Santa Coloma de Gramenet, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Grupo de Riesgo Cardiovascular, Nutrición y Envejecimiento del Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Servicio de Medicina Interna, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El valor clínico de la respuesta hipertensiva exagerada al ejercicio" ] ] "textoCompleto" => "Physical exercise results in increased systolic blood pressure (SBP) due to an increase in cardiac output in response to increased oxygen demand by the musculoskeletal system. However, some individuals have an excessive increase in SBP during exercise. This phenomenon is known as exaggerated hypertensive response to exercise (EHRE). Although there is no consensus on the exact SBP value that defines an EHRE, the first studies defined EHRE as a difference between the SBP peak during the stress test and baseline SBP of at least 60mmHg in men and 50mmHg in women. Alternatively, an EHRE is defined as an SBP greater than the 90th percentile (approximately 210mmHg in men and >190mmHg in women).<a class="elsevierStyleCrossRefs" href="#bib0060">1–3</a> The diagnostic and prognostic implication of EHRE is controversial. A number of experts have considered that the parameter has no clinical relevance while for others it is a marker of cardiovascular morbidity and mortality.<a class="elsevierStyleCrossRef" href="#bib0075">4</a>Numerous studies have shown an inverse association between the level of physical activity and the incidence of cardiovascular disease (CVD), such that inactivity and reduced aerobic capacity are powerful predictors of cardiovascular events and all-cause mortality, both in healthy individuals and in those with established CVD, including patients with arterial hypertension (AHT).<a class="elsevierStyleCrossRef" href="#bib0080">5</a> For this reason, the challenge of Western societies is to promote physical exercise; however, for certain individuals, exercise can entail an EHRE of undetermined prognostic value. The EHRE usually appears in normotensive patients and patients with no previous CVD, although the mechanisms involved and their clinical relevance are still poorly understood. A recent review of 78,163 normotensive individuals supports the relationship between EHRE and the development of AHT and CVD, revealing the need for cardiovascular prevention for these patients.<a class="elsevierStyleCrossRef" href="#bib0085">6</a>The pathophysiological mechanisms involved in EHRE are increasingly well known, such that there is consensus that patients with EHRE have impaired endothelial function, reduced nitric oxide levels, increased arterial stiffness and impaired neurohormonal response characterized by excessive activation of the sympathetic nervous system, as well as high angiotensin II levels.<a class="elsevierStyleCrossRefs" href="#bib0090">7–9</a> It therefore seems reasonable to consider individuals with EHRE to be exposed to a greater preload of the left ventricle, left ventricular hypertrophy and, ultimately, the onset of secondary subendocardial ischemia; however, the data on the association of EHRE and myocardial ischemia are limited and controversial.<a class="elsevierStyleCrossRef" href="#bib0105">10</a> The data published by Bouzas-Mosquera et al.<a class="elsevierStyleCrossRef" href="#bib0110">11</a> in the current issue of Revista Clínica Española provide new evidence on the relationship between EHRE and myocardial ischemia in patients with previous ischemic heart disease. In this study, there was no significant relationship between EHRE and the electrocardiographic abnormalities of ischemia.In conclusion and based on the available evidence, it seems prudent to promote the early diagnosis of AHT, encourage physical exercise for patients with AHT and prevent the onset of future CVD in normotensive patients with EHRE. However, the lack of strong criteria for defining EHRE and the lack of available evidence on the clinical management of normotensive patients with EHRE reveals the need for new prospective clinical studies to clarify these issues." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Sobrino J, Domenech M. El valor clínico de la respuesta hipertensiva exagerada al ejercicio. Rev Clin Esp. 2018;218:13–14." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exaggerated blood pressure response to exercise is associated with augmented rise of angiotensin II during exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.Y. Shim" 1 => "J.W. Ha" 2 => "S. Park" 3 => "E.Y. Choi" 4 => "D. Choi" 5 => "S.J. Rim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2008.03.052" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2008" "volumen" => "52" "paginaInicial" => "287" "paginaFinal" => "292" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18634984" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0065" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angiographic and prognostic implications of an exaggerated exercise systolic blood pressure response and rest systolic blood pressure in adults undergoing evaluation for suspected coronary artery disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.S. Lauer" 1 => "F.J. Pashkow" 2 => "S.A. Harvey" 3 => "T.H. Marwick" 4 => "J.D. Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0735-1097(95)00388-6" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1995" "volumen" => "26" "paginaInicial" => "1630" "paginaFinal" => "1636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7594096" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0070" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic significance of exercise-induced systemic hypertension in healthy subjects" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.G. Allison" 1 => "M.A. Cordeiro" 2 => "T.D. Miller" 3 => "H. Daida" 4 => "R.W. Squires" 5 => "G.T. Gau" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "1999" "volumen" => "83" "paginaInicial" => "371" "paginaFinal" => "375" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10072226" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0075" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endothelial dysfunction and alteration of nitric oxide/cyclic GMP pathway in patients with exercise-induced hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.J. Chang" 1 => "J.H. Chung" 2 => "B.J. Choi" 3 => "T.Y. Choi" 4 => "S.Y. Choi" 5 => "M.H. Yoon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3349/ymj.2003.44.6.1014" "Revista" => array:6 [ "tituloSerie" => "Yonsei Med J" "fecha" => "2003" "volumen" => "44" "paginaInicial" => "1014" "paginaFinal" => "1020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14703610" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0080" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of exercise training on systodiastolic ventricular dysfunction in patients with hypertension: an echocardiographic study with tissue velocity and strain imaging evaluation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Leggio" 1 => "A. Mazza" 2 => "G. Cruciani" 3 => "L. Sgorbini" 4 => "M. Pugliese" 5 => "M.G. Bendini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/hr.2014.44" "Revista" => array:6 [ "tituloSerie" => "Hypertens Res" "fecha" => "2014" "volumen" => "37" "paginaInicial" => "649" "paginaFinal" => "654" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24694644" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0085" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of exaggerated blood pressure response in normotensive individuals on future hypertension and prognosis: systematic review according to PRISMA guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Keller" 1 => "K. Stelzer" 2 => "M.A. Ostad" 3 => "F. Post" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.advms.2016.11.010" "Revista" => array:6 [ "tituloSerie" => "Adv Med Sci" "fecha" => "2017" "volumen" => "62" "paginaInicial" => "317" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28511070" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0090" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.J. Stewart" 1 => "J. Sung" 2 => "H.A. Silber" 3 => "J.L. Fleg" 4 => "M.D. Kelemen" 5 => "K.L. Turner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0895-7061(03)01003-3" "Revista" => array:6 [ "tituloSerie" => "Am J Hypertens" "fecha" => "2004" "volumen" => "17" "paginaInicial" => "314" "paginaFinal" => "320" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15062884" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0095" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The hormonal response to exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Galbo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Diabetes Metab Rev" "fecha" => "1986" "volumen" => "1" "paginaInicial" => "385" "paginaFinal" => "408" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2873006" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0100" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renin-angiotensin-aldosterone system and physical exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F. Fallo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Sports Med Phys Fitness" "fecha" => "1993" "volumen" => "33" "paginaInicial" => "306" "paginaFinal" => "312" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8107485" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0105" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is there a relationship between exercise systolic blood-pressure response and left-ventricular mass? – The Framingham Heart-Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.S. Lauer" 1 => "D. Levy" 2 => "K.M. Anderson" 3 => "J.F. Plehn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1992" "volumen" => "116" "paginaInicial" => "203" "paginaFinal" => "210" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1530806" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0110" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Respuesta hipertensiva exagerada al ejercicio e isquemia miocárdica en pacientes con enfermedad coronaria conocida o sospechada" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Bouzas-Mosquera" 1 => "A. Bouzas-Mosquera" 2 => "J. Peteiro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2018" "volumen" => "218" "paginaInicial" => "7" "paginaFinal" => "12" "itemHostRev" => array:3 [ "pii" => "S0301211517303524" "estado" => "S300" "issn" => "03012115" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021800000001/v1_201801040959/S2254887417301297/v1_201801040959/en/main.assets" "Apartado" => array:4 [ "identificador" => "71812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021800000001/v1_201801040959/S2254887417301297/v1_201801040959/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301297?idApp=WRCEE"]

Revista Clínica Española (English Edition)

ISSN: 2254-8874

Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI).
The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Ten issues are published each year, including mostly originals, reviews and consensus documents.

Indexed in:

Current Contents / Clinical Medicine , JCR / SCI-Expanded, Index Medicus / Medline y Excerpta Medica / EMBASE

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

2.3

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

0.7

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.162

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.211

View more metrics

Open Access Option

Journal Information

Previous article | Next article

Vol. 218. Issue 1.

Pages 13-14 (January - February 2018)

Lee este artículo en Español

Export reference

Download PDF

Article

These are the options to access the full texts of the publication Revista Clínica Española (English Edition)

Member of the society

Subscriber

Contact

Member

Si es usted socio de FESEMI siga los siguientes pasos:

Diríjase desde aquí a la web de la >>>FESEMI<<< e inicie sesión mediante el formulario que se encuentra en la barra superior, pulsando sobre el candado.