[Response of the heart rate and blood pressure to exertion - criterion for the differential therapy of hypertension].

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.