Franz I W
Rehabilitationsklinik Wehrawald der BfA, Todtmoos.
Versicherungsmedizin. 1996 Dec 1;48(6):208-11.
Evaluation of high blood pressure would be greatly facilitated by a standardized test procedure that could enable comparable and reproducible blood pressure determinations to be made. It would also be useful to have a standardized method for monitoring sympathetic activity, so that the occurrence and magnitude of inordinate stress responses could be assessed more accurately. One way to meet these requirements is through standardized ergometric testing at workloads of 50 to 100 watts using increments of 10 watts/min. or 25 watts/2 min. (cuff blood pressure measurements). Between the ages of 20 and 50 years the criteria for a hypertensive response during exercise are blood pressure values of more than 200/100 mmHg (mean + 1 SD of the normotensives) at a workload of 100 watts. In the recovery phase, blood pressure is considered as being hypertensive if a value of 140/90 mmHg ist exceeded in the fifth minute. There are several studies showing that the blood pressure response to ergometry predicts future hypertension in patients with normal resting blood pressure. Patients suffering from mild hypertension showed significantly higher blood pressures at 100 watts and after exercise than age-matched normotensives but significantly lower values than hypertensives with stable hypertension. Ergometric studies also assume a prognostic importance, with respect to prevention of acute and chronic complications of hypertension. Therefore we must require that antihypertensive drugs not only normalize the resting blood pressure, but also lower the blood pressure adequately in stressful situations.
标准化的测试程序将极大地促进高血压的评估,该程序能够进行可比且可重复的血压测定。拥有一种标准化的监测交感神经活动的方法也很有用,这样就能更准确地评估过度应激反应的发生情况和程度。满足这些要求的一种方法是通过标准化的测力计测试,在50至100瓦的工作量下,以每分钟10瓦或每两分钟25瓦的增量进行(袖带血压测量)。在20至50岁之间,运动期间高血压反应的标准是在100瓦的工作量下血压值超过200/100 mmHg(正常血压者的均值 + 1标准差)。在恢复阶段,如果在第五分钟血压值超过140/90 mmHg,则认为血压处于高血压状态。有几项研究表明,测力计测试的血压反应可预测静息血压正常的患者未来是否会患高血压。患有轻度高血压的患者在100瓦时和运动后的血压明显高于年龄匹配的正常血压者,但明显低于患有稳定高血压的患者。测力计研究对于预防高血压的急性和慢性并发症也具有预后重要性。因此,我们必须要求抗高血压药物不仅能使静息血压正常化,还能在压力情况下充分降低血压。