服用不同血管紧张素转换酶抑制剂的高血压患者的运动测试

Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors.

作者信息

Carreira Maria Angela M Q, Tavares Leandro R, Leite Rafaela F, Ribeiro Jamila C, Santos Antônio C, Pereira Karla G, Velarde Guilhermo C, Nóbrega Antonio Claudio L

机构信息

Universidade Federal Fluminense, Niterói, RJ, Brazil.

出版信息

Arq Bras Cardiol. 2003 Feb;80(2):133-7, 127-32. doi: 10.1590/s0066-782x2003000200002. Epub 2003 Feb 25.

DOI:10.1590/s0066-782x2003000200002

PMID:12640507

Abstract

OBJECTIVE

To compare blood pressure response to dynamic exercise in hypertensive patients taking trandolapril or captopril.

METHODS

We carried out a prospective, randomized, blinded study with 40 patients with primary hypertension and no other associated disease. The patients were divided into 2 groups (n=20), paired by age, sex, race, and body mass index, and underwent 2 symptom-limited exercise tests on a treadmill before and after 30 days of treatment with captopril (75 to 150 mg/day) or trandolapril (2 to 4 mg/day).

RESULTS

The groups were similar prior to treatment (p<0.05), and both drugs reduced blood pressure at rest (p<0.001). During treatment, trandolapril caused a greater increase in functional capacity (+31%) than captopril (+17%; p=0.01) did, and provided better blood pressure control during exercise, observed as a reduction in the variation of systolic blood pressure/MET (trandolapril: 10.7 1.9 mmHg/U vs 7.4 1.2 mmHg/U, p=0.02; captopril: 9.1 1.4 mmHg/U vs 11.4 2.5 mmHg/U, p=0.35), a reduction in peak diastolic blood pressure (trandolapril: 116.8 3.1 mmHg vs 108.1 2.5 mmHg, p=0.003; captopril: 118.2 3.1 mmHg vs 115.8 3.3 mmHg, p=0.35), and a reduction in the interruption of the tests due to excessive elevation in blood pressure (trandolapril: 50% vs 15%, p=0.009; captopril: 50% vs 45%, p=0.32).

CONCLUSION

Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.

摘要

目的

比较服用群多普利或卡托普利的高血压患者对动态运动的血压反应。

方法

我们对40例原发性高血压且无其他相关疾病的患者进行了一项前瞻性、随机、双盲研究。患者按年龄、性别、种族和体重指数配对分为2组（每组n = 20），在接受卡托普利（75至150毫克/天）或群多普利（2至4毫克/天）治疗30天前后，在跑步机上进行2次症状限制性运动测试。

结果

治疗前两组相似（p < 0.05），两种药物均能降低静息血压（p < 0.001）。治疗期间，群多普利使功能能力的增加幅度（+31%）大于卡托普利（+17%；p = 0.01），并且在运动期间提供了更好的血压控制，表现为收缩压/代谢当量变化的降低（群多普利：10.7±1.9毫米汞柱/单位，而卡托普利为7.4±1.2毫米汞柱/单位，p = 0.02），峰值舒张压降低（群多普利：116.8±3.1毫米汞柱对108.1±2.5毫米汞柱，p = 0.003；卡托普利：118.2±3.1毫米汞柱对115.8±3.3毫米汞柱，p = 0.35），以及因血压过度升高导致测试中断的情况减少（群多普利：50%对15%，p = 0.009；卡托普利：50%对45%，p = 0.32）。