Diwan S K, Jaiswal Nikhil, Wanjari A K, Mahajan S N
Department of Medicine, JN Medical College, Sawangi Meghe, Wardha 442004.
Indian Heart J. 2005 May-Jun;57(3):237-40.
Longitudinal studies have revealed significant correlation between exaggerated blood pressure response to exercise and higher incidence of developing resting hypertension in future. Normotensive persons at high risk of developing systemic hypertension have greater cardiovascular reactivity to exercise.
Our study compared the blood pressure response to treadmill exercise in normotensive offspring of the hypertensive parents (age 22 +/- 1.7 years, n = 50; study group) with those of the normotensive parents (age 22 +/- 1.4 years, n = 50; control group). The morphometric characteristics, resting, exercise (treadmill exercise with Bruce protocol) and recovery blood pressure values of all the subjects were recorded. The analysis showed that the difference in mean peak systolic blood pressure during exercise was the only statistically significant parameter in the study and control groups (188.52 +/- 25.16 mmHg and 178.56 +/- 14.96 mmHg, respectively, p < 0.05). The number of hyperreactors (defined as peak systolic blood pressure > 200 mmHg during exercise) was significantly more in study group compared to control group (10 and 3 respectively). The mean resting systolic blood pressure of hyperreactors (126.46 + 8.49 mmHg) falls in the pre-hypertension category as designated by JNC VII. Also, their resting diastolic blood pressure, recovery blood pressure and body mass index were significantly higher as compared to normoreactors.
Our study showed that this response pattern could represent impairment in cardiovascular adjustment to exercise indicating a greater risk for development of resting hypertension in the future. Therefore there is a need for early lifestyle modifications to postpone/prevent development of hypertension.
纵向研究表明，运动时血压过度反应与未来发生静息性高血压的较高发生率之间存在显著相关性。有发生系统性高血压高风险的血压正常者对运动具有更大的心血管反应性。
我们的研究比较了高血压患者父母的血压正常的后代（年龄22±1.7岁，n = 50；研究组）与血压正常的父母的后代（年龄22±1.4岁，n = 50；对照组）对跑步机运动的血压反应。记录了所有受试者的形态学特征、静息、运动（采用布鲁斯方案的跑步机运动）和恢复时的血压值。分析表明，运动期间平均收缩压峰值的差异是研究组和对照组中唯一具有统计学意义的参数（分别为188.52±25.16 mmHg和178.56±14.96 mmHg，p < 0.05）。与对照组相比，研究组中反应过度者（定义为运动期间收缩压峰值>200 mmHg）的数量明显更多（分别为10例和3例）。反应过度者的平均静息收缩压（126.46 + 8.49 mmHg）属于美国国家联合委员会第七版（JNC VII）指定的高血压前期类别。此外，与反应正常者相比，他们的静息舒张压、恢复血压和体重指数明显更高。
我们的研究表明，这种反应模式可能代表心血管对运动的调节受损，表明未来发生静息性高血压的风险更大。因此，需要尽早改变生活方式以推迟/预防高血压的发生。
