Inova Health System, Betty and Guy Beatty Center for Integrated Research, Falls Church, VA, USA.
Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA.
J Clin Hypertens (Greenwich). 2020 Oct;22(10):1915-1923. doi: 10.1111/jch.13938. Epub 2020 Sep 17.
People with Hepatitis C (HCV) and non-alcoholic fatty liver disease (NAFLD) in the United States follow national trends toward a sedentary lifestyle and are increasingly at risk for hypertension. The intent of this study was to identify potential correlates of exercise tolerance in people with two types of chronic liver disease (CLD)-NAFLD and HCV. Measures included cardiac output, oxygen consumption and stroke volume, blood pressure, distance walked in 6 minutes, clinical laboratory tests, and medications influencing the autonomic nervous system, patient self-reports of activity, fatigue, and health-related quality of life (HRQL). A total of 67 patients completed the 6-minute walk test [45.1% Female, Age 51.7 ± 8.0 years, Body Mass Index 32.8 ± 5.9, 60% HCV]. At baseline, 70% had either diastolic (DBP) or systolic blood pressure outside normal range. Performance and cardiorespiratory measures correlated strongly with one another, but not with activity. Patients with abnormal DBP reported significantly lower maximum activity (MAS; r = -.254, P = .041, CI = -0.51 to -0.010; MAS 70.6 vs 82.5), significantly higher DBP post-6-minute walk test (r = .524, P = .0001, CI = 0.287-0.762) and significantly lower overall HRQL items related to physical domains (r = .273, P = .029, CI = -0.518 to -0.029). Mental-domain HRQL and depression measures did not correlate significantly with blood pressure. This study reports a significant correlation between both pre-hypertensive and hypertensive DBP, poor physical-domain self-reports, HRQL, and performance in CLD patients.
美国患有丙型肝炎 (HCV) 和非酒精性脂肪性肝病 (NAFLD) 的人群遵循着久坐不动的生活方式，高血压的风险日益增加。本研究旨在确定两种慢性肝病 (CLD)-NAFLD 和 HCV 患者运动耐量的潜在相关因素。测量包括心输出量、耗氧量和每搏输出量、血压、6 分钟步行距离、临床实验室检查以及影响自主神经系统的药物、患者的活动、疲劳和健康相关生活质量 (HRQL) 自我报告。共有 67 名患者完成了 6 分钟步行测试[女性占 45.1%，年龄 51.7±8.0 岁，体重指数 32.8±5.9，60%HCV]。基线时，70%的患者舒张压 (DBP) 或收缩压超出正常范围。表现和心肺测量指标彼此之间高度相关，但与活动无关。DBP 异常的患者报告的最大活动量 (MAS) 明显较低(r=-.254，P=.041，CI=-0.51 至 -0.010；MAS 为 70.6 比 82.5)，6 分钟步行试验后 DBP 明显升高(r=0.524，P=0.0001，CI=0.287-0.762)，与身体领域相关的整体 HRQL 项目明显较低(r=0.273，P=0.029，CI=-0.518 至 -0.029)。心理领域的 HRQL 和抑郁测量指标与血压无显著相关性。本研究报告了 CLD 患者的 DBP 升高、血压升高、身体领域自我报告不佳、HRQL 差和运动能力下降之间存在显著相关性。
