A healthy adult begins graded treadmill exercise from rest to maximal effort. Which of the following correctly describes the blood pressure response?
- A Both systolic and diastolic pressure rise equally, so mean arterial pressure doubles
- B Diastolic pressure rises markedly while systolic pressure remains stable, narrowing pulse pressure
- C Systolic pressure rises markedly while diastolic pressure remains stable or falls slightly, widening pulse pressure ✓
- D Both systolic and diastolic pressures fall due to widespread vasodilation overriding the cardiac output increase
Correct answer: C. Systolic pressure rises markedly while diastolic pressure remains stable or falls slightly, widening pulse pressure
Explanation
During dynamic exercise, systolic pressure rises substantially due to increased cardiac output, while total peripheral resistance falls from skeletal muscle vasodilation. Diastolic pressure stays near resting levels or falls slightly. The widened pulse pressure reflects the high stroke volume and low peripheral resistance. The equal-rise option is wrong because peripheral resistance does not rise during dynamic exercise.
Reference: Ganong's Review of Medical Physiology, 26th ed.
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