Franz I W
Cardiac Rehabilitation Center, Klinik Wehrawald der BfA, Berlin, Germany.
Can J Sport Sci. 1991 Dec;16(4):296-301.
Hypertensive patients have lower cardiac outputs and stroke volumes, higher heart rates, and a markedly higher peripheral resistance than normotensive individuals at the same intensity of exercise. Even patients with mildly elevated resting blood pressures have a markedly increased myocardial oxygen demand during exercise; since demand is determined not only by the pressure load but also by the degree of ventricular hypertrophy, three therapeutic inferences may be drawn: (a) Endurance training offers hypertensive patients a means of lowering exercise heart rate, reducing the systolic blood pressure and myocardial oxygen consumption, and also improving physical work capacity. (b) Besides avoiding isometric exercise, due to possible excessive peaks of blood pressure, all patients should be evaluated by ergometric testing before beginning an exercise training programme. (c) If ergometry reveals a marked rise in blood pressure at low levels of exertion, then appropriate antihypertensive medication (beta-blockers, calcium antagonists) should be prescribed prior to training.
与血压正常的个体相比，高血压患者在相同运动强度下，心输出量和每搏输出量更低，心率更高，外周阻力显著更高。即使静息血压轻度升高的患者在运动期间心肌需氧量也会显著增加；由于需氧量不仅取决于压力负荷，还取决于心室肥厚程度，因此可以得出三个治疗推断：(a) 耐力训练为高血压患者提供了一种降低运动心率、降低收缩压和心肌耗氧量以及提高体力工作能力的方法。(b) 除了避免等长运动（因为可能出现血压过度峰值）外，所有患者在开始运动训练计划前都应通过测力计测试进行评估。(c) 如果测力计测试显示在低运动水平时血压显著升高，则应在训练前开具适当的抗高血压药物（β受体阻滞剂、钙拮抗剂）。
