Fagard R, Staessen J, Amery A
Department of Pathophysiology, Faculty of Medicine, University of Leuven, Belgium.
J Hypertens. 1988 Nov;6(11):859-65. doi: 10.1097/00004872-198811000-00003.
Fifty untreated male patients aged 32 +/- 10 (s.d.) years, referred for hypertension, in whom organ damage was limited to WHO stages I and II, without underlying disease, performed a graded, uninterrupted exercise on a bicycle ergometer up to exhaustion. Mean brachial intra-arterial pressure at rest ranged from 74 to 152 mmHg. Maximal voluntary oxygen uptake was independently and negatively related to resting blood pressure (P less than 0.05), age (P = 0.05), and positively to body weight (P less than 0.05). Pulmonary wedge pressure and the components of the Fick equation--heart rate, stroke volume and arteriovenous oxygen difference--were measured in order to study the mechanisms involved. Stroke volume at peak exercise was inversely (P less than 0.05), and pulmonary wedge pressure positively (P less than 0.01), related to mean brachial artery pressure at rest. Peak heart rate was not significantly related to the severity of hypertension, but was inversely related to age (P less than 0.01). Stroke volume and pulmonary wedge pressure at the end of exercise were both similar in older and younger patients. Arteriovenous oxygen difference at peak exercise was not related either to blood pressure or to age. In conclusion, both high blood pressure and age reduce maximal voluntary oxygen uptake independently of each other by separate mechanisms; the former by an impairment of cardiac function, the latter by the limitation of peak heart rate.
50名年龄在32±10（标准差）岁的未经治疗的男性高血压患者，其器官损害仅限于世界卫生组织I期和II期，无基础疾病，在自行车测力计上进行分级、不间断运动直至力竭。静息时肱动脉平均血压范围为74至152 mmHg。最大自主摄氧量与静息血压（P<0.05）、年龄（P = 0.05）呈独立负相关，与体重呈正相关（P<0.05）。测量肺楔压和菲克方程的组成部分——心率、每搏输出量和动静脉氧分压差，以研究其中涉及的机制。运动峰值时的每搏输出量与静息时肱动脉平均血压呈负相关（P<0.05），肺楔压呈正相关（P<0.01）。峰值心率与高血压严重程度无显著相关性，但与年龄呈负相关（P<0.01）。运动结束时老年患者和年轻患者的每搏输出量和肺楔压均相似。运动峰值时的动静脉氧分压差与血压和年龄均无关。总之，高血压和年龄通过不同机制相互独立地降低最大自主摄氧量；前者通过损害心脏功能，后者通过限制峰值心率。
