Functional exercise tests in hypertensive patients should be considered a „service test“ helping in the decision on pharmacotherapy or its modification. Technical aspects as well as validity of exercise test results in children and adolescents are discussed. Comparing various reference values as well as our own experience it is clear that blood pressure (BP) during exercise depends on the type of exercise, previous day load, and on the psychological background of the test. BP during exercise displays also gender and racial difference. The relative intensity (i.e. percentage of maximal load) should also be taken into account. Exercise test interpretation involves specific problems and cannot be replaced by 24-hour blood pressure monitoring. Recommendations: 1. Exercise BP can help in decisions for pharmacotherapy of hypertension in children and young adults. 2. Interpretative analysis of results needs experience, adequate choice of exercise protocol and accurately defined reference values. 3. In patients with very high physical activity and borderline or high exercise BP values periodically repeated exercise tests are recommended. 4. Repeated exercise tests should also be performed in case of substantial change of BP at rest and after any change in antihypertensive medication.

        Key words: hypertension in childhood and adolescents, exercise test interpretation, exercise blood pressure reference values