Guerrera G, Melina D, Felici C, Colivicchi F, Santoliquido A, Guerrera C, Musumeci V, Folli G
Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Roma.
Cardiologia. 1990 Dec;35(12):997-1004.
Aim of this study was to assess blood pressure (BP) response to exercise in borderline hypertensive subjects and to evaluate its predictive value for subsequent established hypertension development: 74 male subjects (28 borderline subjects, 26 normotensive subjects and 20 subjects with established hypertension) underwent a maximal exercise testing in the sitting position with a bicycle ergometer at the beginning of the study and then after 1 and 2 years; besides casual BP was controlled every 3 months for 2 years. Systolic BP exceeding 220 and/or diastolic BP exceeding 105 mmHg at maximal exercise and/or diastolic BP exceeding 100 mmHg at th fifth min of recovery were considered as abnormal. On the basis of BP response to exercise we divided our study group in: normotensive subjects with a normal BP response (Group A: 88%); normotensive subjects with an abnormal BP response (Group B: 12%); borderline subjects with a normal BP response (Group C: 46%); borderline subjects with an abnormal BP response (Group D:56%). At the end of a 2-year follow-up established hypertension developed in 1 subject of Group B (33%), in 2 subjects of Group C (15%) and in 10 subjects of Group D (67%); 7 subjects of Group C returned to normotension (54%). The incidence of established hypertension is significantly higher in borderline subjects with an abnormal BP response to exercise. This finding is probably due to both functional and organic factors and stresses the predictive value of exercise testing in borderline hypertension.
本研究的目的是评估临界高血压患者运动时的血压(BP)反应,并评估其对随后发生的确诊高血压的预测价值:74名男性受试者(28名临界高血压受试者、26名血压正常受试者和20名确诊高血压受试者)在研究开始时、1年后和2年后使用自行车测力计进行了坐位最大运动测试;此外,在2年的时间里,每3个月测量一次日常血压。最大运动时收缩压超过220mmHg和/或舒张压超过105mmHg,和/或恢复第5分钟时舒张压超过100mmHg被视为异常。根据运动时的血压反应,我们将研究组分为:血压反应正常的血压正常受试者(A组:88%);血压反应异常的血压正常受试者(B组:12%);血压反应正常的临界高血压受试者(C组:46%);血压反应异常的临界高血压受试者(D组:56%)。在2年的随访结束时,B组有1名受试者(33%)发展为确诊高血压,C组有2名受试者(15%),D组有10名受试者(67%);C组有7名受试者恢复为血压正常(54%)。运动时血压反应异常的临界高血压受试者确诊高血压的发生率显著更高。这一发现可能是由于功能和器质性因素共同导致的,并强调了运动测试在临界高血压中的预测价值。