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[稳定型动脉高血压患者进行渐进性肌肉运动时的动脉血压行为]

[Arterial blood pressure behavior during progressive muscular exercise in subjects with stable arterial hypertension].

作者信息

Seguro C, Sau F, Zedda N, Scano G, Cherchi A

机构信息

Istituto di Cardiologia, Università degli Studi, Cagliari.

出版信息

Cardiologia. 1991 Nov;36(11):867-77.

PMID:1817759
Abstract

To assess the behaviour of blood pressure (BP) during exercise in hypertensive patients (H), 103 males aged 21 to 59 years (mean 43 years) with essential hypertension WHO class I-II were studied. All H, without antihypertensive therapy for at least 15 days, underwent sitting bicycle exercise (10 W/min). BP was measured on the left arm by a standard mercury sphygmomanometer. The fifth Korotkoff phase was taken as the diastolic pressure. Heart rate was measured by electrocardiogram. Subjects were studied at rest in sitting position, during exercise every 3 min and during recovery at 1, 3 and 5 min. As controls we took 100 normotensive (N) males aged 20 to 59 years (mean 39 years). The results were analyzed also by decades. Systolic (S) and diastolic (D) blood pressure were higher in H in comparison with N at rest, in sitting position, (N 119 +/- 10/79 +/- 7 mmHg; H 162 +/- 21/112 +/- 11 mmHg; p less than 0.01), during exercise and recovery. SBP and, to a lesser extent DBP, progressively increased during exercise both in N and in H patients (at peak exercise: N 192 +/- 20/85 +/- 13 mmHg; H 239 +/- 25/121 +/- 13 mmHg, p less than 0.01). The mean increase of SBP during exercise was 77 mmHg in H and 73 mmHg in N (NS). DBP increment was about 6 mmHg in N and 9 mmHg in H (NS). Within the age decades, SBP during exercise was higher in the age group of 50 to 59 in comparison with 20 to 29 in N and H (p less than 0.05) and DBP in the age group of 40 to 49 and 50 to 59 in comparison with 20 to 29 and 30 to 39 (p less than 0.01). The fall of SBP and DBP was greater at 1 min of recovery both in H and N and became progressively smaller thereafter. At a same workload (90 and 120 W) 60% of H had SBP and 85% had DBP higher than BP in N (above 200/104 mmHg--mean + 2 SD--at 90 W and 215/106 mmHg at 120 W). No difference was observed in heart rate at rest and during exercise between N and H. In conclusion, H had SBP and DBP higher at rest, during exercise and recovery in comparison with N. However, a parallel increase of BP was found in the 2 groups during exercise. Ergometric test showed that 60-85% of H had also excessive increase of systolic and diastolic blood pressure during exercise.

摘要

为评估高血压患者(H组)运动期间的血压(BP)变化情况,我们对103名年龄在21至59岁(平均43岁)、患有世界卫生组织I-II级原发性高血压的男性进行了研究。所有H组患者至少15天未接受抗高血压治疗,他们进行了坐姿自行车运动(10瓦/分钟)。使用标准汞柱式血压计测量左臂血压,以柯氏音第5相作为舒张压。通过心电图测量心率。研究对象在静息坐姿状态下、运动期间每3分钟以及运动恢复后的第1、3和5分钟进行检测。作为对照,我们选取了100名年龄在20至59岁(平均39岁)的血压正常(N组)男性。结果也按十年年龄段进行了分析。在静息坐姿状态下、运动期间及恢复过程中,H组的收缩压(S)和舒张压(D)均高于N组(N组:119±10/79±7 mmHg;H组:162±21/112±11 mmHg;p<0.01)。N组和H组患者在运动期间收缩压(SBP)均逐渐升高,舒张压(DBP)升高幅度相对较小(运动峰值时:N组192±20/85±13 mmHg;H组239±25/121±13 mmHg,p<0.01)。H组运动期间SBP平均升高77 mmHg,N组平均升高73 mmHg(无显著差异)。N组DBP升高约6 mmHg,H组升高约9 mmHg(无显著差异)。在各年龄十年段中,N组和H组50至59岁年龄组运动期间的SBP高于20至29岁年龄组(p<0.05),40至49岁和50至59岁年龄组的DBP高于20至29岁和30至39岁年龄组(p<0.01)。H组和N组在运动恢复1分钟时SBP和DBP下降幅度均较大,此后逐渐减小。在相同工作量(90瓦和120瓦)下,60%的H组患者SBP和85%的患者DBP高于N组(90瓦时高于200/104 mmHg——均值+2标准差——,120瓦时高于215/106 mmHg)。N组和H组在静息及运动期间心率未观察到差异。总之,与N组相比,H组在静息、运动及恢复期间SBP和DBP均较高。然而两组在运动期间血压呈平行升高。测力计测试显示60% - 85%的H组患者在运动期间收缩压和舒张压也过度升高。

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