Brenner R, Allemann Y
Universitätsklinik für Kardiologie, Inselspital, Universitätsspital Bern.
Praxis (Bern 1994). 2011 Aug 24;100(17):1041-9. doi: 10.1024/1661-8157/a000638.
Cardiac monitoring with ECG and blood pressure recording is routinely performed during a stress test and blood pressure response is an important part of its interpretation. Unfortunately, the latter is not straightforward, partly because of the inconsistent definition of a pathologic blood pressure response, the different populations included in the studies and divergent test modalities. An exaggerated blood pressure response in normotensive subjects without coronary heart disease is associated with an increased risk of future arterial hypertension, whereas in patients with known or suspected coronary heart disease, prognosis is not worse than in patients with normal blood pressure response. By contrast, exercise induced hypotension, particularly in patients with coronary artery disease indicates an increased risk for cardiac events and should be investigated further, usually by performing coronary angiography.
在压力测试期间常规进行心电图和血压记录的心脏监测，血压反应是其解读的重要部分。不幸的是，后者并不简单，部分原因在于病理性血压反应的定义不一致、研究中纳入的不同人群以及不同的测试方式。血压正常且无冠心病的受试者出现的血压反应过度与未来发生动脉高血压的风险增加有关，而在已知或疑似患有冠心病的患者中，其预后并不比血压反应正常的患者更差。相比之下，运动诱发的低血压，尤其是在冠状动脉疾病患者中，表明心脏事件风险增加，应进一步进行调查，通常通过冠状动脉造影来进行。
