Which antihypertensive medications increase the risk of post-exercise hypotension?

• A. Alpha-blockers
• B. ACE inhibitors
• C. Beta-blockers
• D. Diuretics

Answer: (A)

Post-exercise hypotension happens when blood pressure falls after finishing activity because vasodilation persists and the normal sympathetic reflex to constrict blood vessels is slower to kick in. Blocking alpha-1 receptors on vascular smooth muscle prevents norepinephrine from triggering vasoconstriction, so there’s less ability to compensate for the sudden drop in vascular resistance after exercise. With this reduced constrictor response, blood can pool in the legs and systemic pressure drops more easily and for longer than usual. Other antihypertensives don’t blunt this reflex vasoconstriction in the same way—ACE inhibitors and diuretics mainly reduce BP by different mechanisms, and beta-blockers blunt heart rate rather than the vasodilatory response—so they’re less associated with post-exercise hypotension.