Kucukler Nagehan, Yalçin Fatih, Abraham Theodore P, Garcia Mario J
Johns Hopkins Medical Institutions, Department of Cardiology, Baltimore, MD, USA.
Cardiovasc Ultrasound. 2011 Aug 16;9:22. doi: 10.1186/1476-7120-9-22.
Various diagnostic methods have been used to evaluate hypertensive patients under physical and pharmacological stress. Several studies have shown that exercise hypertension has an independent, adverse impact on outcome; however, other prognostic studies have shown that exercise hypertension is a favorable prognostic indicator and associated with good outcome. Exercise hypertension may be encountered as a warning signal of hypertension at rest and future hypertensive left ventricular hypertrophy. The results of diagnostic stress tests support that hypertensive response to exercise is frequently associated with high rate-pressure product in hypertensives. In addition to the observations on high rate-pressure product and enhanced ventricular contractility in patients with hypertension, evaluation of myocardial contractility by Doppler tissue imaging has shown hyperdynamic myocardial function under pharmacological stress. These recent quantitative data in hypertensives suggest that hyperdynamic myocardial function and high rate-pressure product response to stress may be related to exaggerated hypertension, which may have more importance than that it has been already given in clinical practice.
已经采用了各种诊断方法来评估处于生理和药物应激状态下的高血压患者。多项研究表明，运动性高血压对预后有独立的不良影响；然而，其他预后研究表明，运动性高血压是一个有利的预后指标，与良好的预后相关。运动性高血压可能是静息高血压和未来高血压性左心室肥厚的一个警示信号。诊断性应激试验的结果支持，高血压患者运动时的高血压反应常与高心率-血压乘积相关。除了对高血压患者高心率-血压乘积和增强的心室收缩性的观察外，通过多普勒组织成像评估心肌收缩性显示在药物应激下心肌功能亢进。高血压患者的这些最新定量数据表明，心肌功能亢进和对应激的高心率-血压乘积反应可能与过度高血压有关，这在临床实践中可能比目前所认识到的更为重要。
