Behn P, Burtzik K, Ziesenhenn K
Z Gesamte Inn Med. 1980 Dec 15;35(24):866-73.
In 37 patients with essential hypertension (WHO-stage I and II) ergometric examinations with submaximum stress were performed in sitting position for the judgement of the behaviour of heart rate and blood pressure (control group 20 clinically healthy persons). On account of the different behaviour of the heart rate the patients could be subdivided into 4 groups: A: normal heart rate in rest and under stress. B: heart rate increased only under stress. C: heart rate increased already in rest. Group D consisted of patients with hypertensive disturbance of the regulation (normal blood pressure immediately before ergometry). In 12 of the patients were also performed ergometric examinations under therapy: in group A the combined use of beta-receptor blocker and saluretic was necessary, in the groups B, C and D monotherapy with beta-receptor blocker was sufficient. The opinion is uttered that an abundant increase of blood pressure under stress in anamnestically known increased values of blood pressure in rest is also an indication to therapy as the appearance of very varying and on an average occasionally increased blood pressure values. In group A (normal regulation of frequency) by the beta-receptor blocker alone as a rule no sufficient effect is expected, the combination with a saluretic is necessary. In the other groups apart from the regulation of the blood pressure also the regulation of the heart rate is disturbed (among others reduction of the vagal inhibition of the heart, lack of training) and apart from the medicamentous therapy with beta-receptor blockers also a physical training is to be recommended. The different patterns of reaction which were to be proved by means of ergometry in patients with hypertension may in most cases be supposed already by the observation of the course and thus be included in the consideration concerning the differential therapy.
对37例原发性高血压患者（WHO分期I期和II期）采用坐位进行亚极量负荷运动测试，以判断心率和血压的变化情况（对照组为20名临床健康者）。根据心率变化情况，患者可分为4组：A组：静息和运动时心率正常。B组：仅运动时心率增加。C组：静息时心率就已增加。D组由调节功能高血压紊乱患者组成（运动测试前血压正常）。12例患者在治疗期间也进行了运动测试：A组需联合使用β受体阻滞剂和利尿剂，B组、C组和D组单用β受体阻滞剂治疗就足够。有人认为，对于既往静息血压升高且运动时血压大幅升高的患者，即使血压值变化很大且平均偶尔升高，也应进行治疗。在A组（频率调节正常），通常仅使用β受体阻滞剂预期效果不佳，需联合使用利尿剂。在其他组中，除了血压调节异常外，心率调节也受到干扰（包括迷走神经对心脏抑制作用减弱、缺乏锻炼等），除了使用β受体阻滞剂进行药物治疗外，还建议进行体育锻炼。高血压患者通过运动测试所证实的不同反应模式，大多数情况下通过观察病情发展即可推测出来，从而纳入鉴别治疗的考虑范围。
