Mirat Jure, Bernat Robert, Majdancić Zeljko, Kolcić Ivana, Galić Edvard, Zeljko Hrvojka, Bergovec Mijo, Reiner Zeljko
Department of Cardiology, General Hospital "Sveti Duh", Zagreb, Croatia.
Coll Antropol. 2007 Jun;31(2):517-22.
The aim of the study was to assess the relationship between systolic blood pressure during maximal treadmill test (SBP9mtt)) and flow-mediated vasodilation (FMD). Abnormal rise of SBP(mtt) is the phenomenon more frequent in hypertensive persons but it could be found in normotensive subjects too. 199 subjects referred to treadmill test were enrolled in the study. Four groups were formed: hypertensives with abnormal SBP(mtt) (group A), hypertensives with normal SBP(mtt) (group B), normotensives with abnormal SBP(mtt) (group C) and normotensives with normal SBP(mtt) (group D). Rise of SBP(mtt) above 200 mmHg was considered abnormal reaction. Simple linear regression analysis showed significant inverse relationship between SBP(mtt) and FMD (F = 20.2036, p < 0.001, R2 = 0.0956). Mean FMD index was worst in hypertensive subjects with abnormal SBP(mtt) (group A), followed by normotensives with abnormal SBP(mtt) (group C), hypertensives with normal SBP(mtt) (group B) and the best was in normotensives with normal SBP(mtt) (3.56 +/- 5.17, 4.19 +/- 5.14, 6.81 +/- 8.43 and 10.92 +/- 7.48%, respectively). In multivariate regression analysis FMD showed significant association with abnormal SBP(mtt) (p < 0.001) along with brachial artery diameter (p < 0.001), male gender (p < 0.001), but not with hypertension (p = 0.073), BMI (p = 0.137) and total cholesterol (p = 0.23) (coefficients: -0.26, -0.40, -0.27, -0.13, -0.11 and -0.07, respectively). There was a significant inverse relationship between SBP(mtt) and FMD. An impairment of FMD exists in normotensive subjects with abnormal SBP(mtt). In hypertensives with abnormal SBP(mtt) an additional impairment of FMD exists when compared to hypertensives with normal SBP(mtt). Abnormal SBP(mtt) should be taken into account in global cardiovascular risk assessment.
该研究的目的是评估最大运动平板试验期间的收缩压（SBP9mtt）与血流介导的血管舒张（FMD）之间的关系。SBP（mtt）异常升高在高血压患者中更为常见，但在血压正常的受试者中也可能出现。199名接受运动平板试验的受试者参与了该研究。研究分为四组：SBP（mtt）异常的高血压患者（A组）、SBP（mtt）正常的高血压患者（B组）、SBP（mtt）异常的血压正常者（C组）和SBP（mtt）正常的血压正常者（D组）。SBP（mtt）升高超过200 mmHg被视为异常反应。简单线性回归分析显示SBP（mtt）与FMD之间存在显著的负相关（F = 20.2036，p < 0.001，R2 = 0.0956）。平均FMD指数在SBP（mtt）异常的高血压患者（A组）中最差，其次是SBP（mtt）异常的血压正常者（C组）、SBP（mtt）正常的高血压患者（B组），最好的是SBP（mtt）正常的血压正常者（分别为3.56 +/- 5.17、4.19 +/- 5.14、6.81 +/- 8.43和10.92 +/- 7.48%）。在多变量回归分析中，FMD与SBP（mtt）异常（p < 0.001）、肱动脉直径（p < 0.001）、男性性别（p < 0.001）显著相关，但与高血压（p = 0.073）、BMI（p = 0.137）和总胆固醇（p = 0.23）无关（系数分别为 -0.26、-0.40、-0.27、-0.13、-0.11和 -0.07）。SBP（mtt）与FMD之间存在显著的负相关。SBP（mtt）异常的血压正常者存在FMD受损情况。与SBP（mtt）正常的高血压患者相比，SBP（mtt）异常的高血压患者存在额外的FMD受损。在整体心血管风险评估中应考虑SBP（mtt）异常情况。
