Potempa K M, Folta A, Braun L T, Szidon J P
University of Illinois, Chicago 60612.
Heart Lung. 1992 Nov-Dec;21(6):509-14.
To investigate the relationship between clinic resting blood pressure (BP) and exercise BP in subjects with established essential hypertension during placebo and propranolol-treated phases.
Prospective, placebo-controlled, cross-over trial.
University-affiliated medical center.
A convenience sample of 38 patients with essential hypertension, 34 men and four women, who ranged in age from 22 to 62 years (mean = 44 years, SD = 10.7). Subjects were diagnosed with mild to moderate diastolic or mixed systolic/diastolic essential hypertension at least 1 year before study entry. They had no clinical evidence of secondary hypertension, diabetes, heart, liver, pulmonary, or renal disease.
Resting and exercise BP.
Antihypertensive medication was tapered off and subjects were free of all prescription drug treatment for 2 weeks. They received placebo for an additional 2 weeks. Subjects then received treatment with propranolol at a dose necessary to control resting blood pressure for 4 to 6 weeks. At the end of both the untreated and treated phases, subjects were given a graded maximal exercise test on a bicycle ergometer.
Propranolol effectively reduced mean resting and maximal exercise BP. The nonsignificant correlation between clinic resting and maximal exercise systolic BP was low in both phases. The correlation between clinic resting and maximal exercise diastolic BP was only moderate, but statistically significant (untreated, r = 0.43; p < 0.01; treated, r = 0.53; p < 0.001). For systolic BP or diastolic BP, there were no significant relationships between percent drop in BP because of propranolol at rest or maximal exercise. Clinic resting BP was not a valid predictor of maximal exercise BP. Degree of control of clinic resting BP was not a valid predictor of control observed at maximal exercise.
Resting BP should not be used as a predictor of BP during maximal exercise in the untreated condition or with treatment with propranolol.
研究在服用安慰剂和普萘洛尔治疗阶段，已确诊的原发性高血压患者的临床静息血压（BP）与运动血压之间的关系。
前瞻性、安慰剂对照、交叉试验。
大学附属医院医疗中心。
选取38例原发性高血压患者作为便利样本，其中34例男性，4例女性，年龄在22至62岁之间（平均 = 44岁，标准差 = 10.7）。受试者在研究入组前至少1年被诊断为轻度至中度舒张期或混合性收缩期/舒张期原发性高血压。他们没有继发性高血压、糖尿病、心脏、肝脏、肺部或肾脏疾病的临床证据。
静息血压和运动血压。
逐渐减少抗高血压药物剂量，受试者在2周内不使用任何处方药治疗。他们再接受2周的安慰剂治疗。然后受试者接受普萘洛尔治疗，剂量以控制静息血压所需为准，持续4至6周。在未治疗阶段和治疗阶段结束时，受试者在自行车测力计上进行分级最大运动试验。
普萘洛尔有效降低了平均静息血压和最大运动血压。在两个阶段，临床静息收缩压与最大运动收缩压之间的非显著相关性都较低。临床静息舒张压与最大运动舒张压之间的相关性仅为中等，但具有统计学意义（未治疗时，r = 0.43；p < 0.01；治疗时，r = 0.53；p < 0.001）。对于收缩压或舒张压，静息或最大运动时因普萘洛尔导致的血压下降百分比之间没有显著关系。临床静息血压不是最大运动血压的有效预测指标。临床静息血压的控制程度不是最大运动时观察到的控制情况的有效预测指标。
在未治疗状态或使用普萘洛尔治疗时，静息血压不应被用作最大运动时血压的预测指标。
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