Longás Tejero M A, Casanovas Lenguas J A
Servicios de Cardiología, Hospital Reina Sofía, Tudela, Navarra.
Rev Esp Cardiol. 1996 Feb;49(2):104-10.
We examined the prevalence of hypertensive response to exercise in a group of healthy young male athletes and evaluate the relationship between this exaggerated blood pressure response to exercise and left ventricular mass.
We studied 37 healthy male athletes (18 soccer players, 12 mountain climbers and 7 canoeists) at a similar level of physical conditioning at the time of the study. The age ranged from 16 to 37 (mean +/- SD: 25.9 +/- 6 yrs.). They underwent basal measurements of heart rate and blood pressure, maximum cycle ergometry in the erect position (increasing 50 W each 3 minutes until exhaustion) and basal echocardiography-Doppler. The statistical analysis was performed using a non-paired Student-t-test.
A hypertensive response to exercise was observed in 8 of the 37 athletes (21.6%). In these 8 athletes the mean left ventricular mass index was 204.88 +/- 63.22 g/m2 estimated by echocardiography, whereas the mean in athletes without exaggerated blood pressure response to exercise was 143.29 +/- 27.51 g/m2 (p < 0.0001). All the athletes with hypertensive response to exercise showed left ventricular hypertrophy, being severe in 75% of them. Of the athletes without hypertensive response to exercise, 44.9% did not exhibit left ventricular hypertrophy. A left ventricular mass index of > or = 190 g/m2 was observed in 50% of athletes with exaggerated blood pressure response to exercise, versus only 6.8% of athletes without it.
A fairly high prevalence of hypertensive response to exercise was observed in our series of healthy young male athletes. The athletes with exaggerated blood pressure response to exercise exhibited a significantly greater left ventricular mass than athletes without it. According to current general knowledge, this group of healthy athletes with hypertensive response to exercise could be prone to develop future chronic high blood pressure at rest and non-physiologic left ventricular hypertrophy. Thus, ergometry may be a useful test to prospectively identify a group of individuals at increased risk for developing essential arterial hypertension, potentially allowing early intervention before hypertension may contribute to cardiovascular risk.
我们研究了一组健康年轻男性运动员运动性高血压反应的患病率，并评估这种过度的运动血压反应与左心室质量之间的关系。
我们研究了37名健康男性运动员（18名足球运动员、12名登山运动员和7名单桨划手），在研究时他们的身体状况处于相似水平。年龄范围为16至37岁（平均±标准差：25.9±6岁）。他们接受了心率和血压的基础测量、直立位最大运动负荷试验（每3分钟增加50瓦直至疲劳）以及基础超声心动图 - 多普勒检查。采用非配对学生t检验进行统计分析。
37名运动员中有8名（21.6%）出现运动性高血压反应。在这8名运动员中，通过超声心动图估计的平均左心室质量指数为204.88±63.22 g/m²，而无过度运动血压反应的运动员平均为143.29±27.51 g/m²（p<0.0001）。所有有运动性高血压反应的运动员均表现出左心室肥厚，其中75%为重度。在无运动性高血压反应的运动员中，44.9%未表现出左心室肥厚。在有过度运动血压反应的运动员中，50%的左心室质量指数≥190 g/m²，而在无此反应的运动员中仅为6.8%。
在我们这组健康年轻男性运动员中观察到运动性高血压反应的患病率相当高。有过度运动血压反应的运动员左心室质量明显大于无此反应的运动员。根据目前的一般认识，这组有运动性高血压反应的健康运动员未来可能更容易出现静息时的慢性高血压和非生理性左心室肥厚。因此，运动负荷试验可能是一种有用的检查方法，可前瞻性地识别出一组患原发性动脉高血压风险增加的个体，有可能在高血压导致心血管风险之前进行早期干预。
