老年高血压病患者运动血压和心率变异关系的初探

Correlation between exercise blood pressure and heart rate variability in aged patients with hypertension

目的:探讨老年高血压病患者运动血压和心奉变异的关系。方法:入选血压控制良好的老年高血压病患者100例,分别给予踏车运动试验和24小时动态心电图测定心率变异(HRV)。按运动试验中最大运动量时收缩压(peakSBP)分为反应过高(A组)和反应正常(B组)2组,以运动停止6分钟后收缩压(recSBP)分为恢复慢(C组)和恢复正常(D组)2组,对比分析各组心率变异各指标的差异。结果:A组心率变异指标PNN 50,rMSSD,SDSD,SDNNI均显著高于B组(P<0.05或<0.01),多元逐步回归分析显示,peakSBP与SDNNI显著正相关(r=0.46)。C组与D组比较,心率变异各指标无统计学意义(P>0.05)。结论:老年高血压病运动血压过度升高可能与自主神经调节功能失调有关,其中SDNNI与peakSBP显著正相关,值得进一步研究。

Objective: To explore the correlation between exercise blood pressure and heart rate variability (HRV) in aged patients with hypertension. Methods: A total of 100 aged patients with hypertension performed exercise test and Holter examine for HRV measure. They were randomly divided into super-response group (group A) and normal response group (group B) according peak systolic blood pressure (peakSBP) in exercise; recovery slowing group (group C) and normai recovery group (group D) according SBP after 6 min post exercise. Results: Compared with group B the HRV indexes: SDNNI, PNN50, rMSSD, SDSD significantly increased (P<0. 05-<0. 01). Multivariate stepwise regression analyzes showed there was significant positive correlation between peakSBP and SDNNI (r=0. 46). There was no significant difference in HRV indexes between group C and group D. Conclusion: Dysfunction of autonomie nerve may be the cause of super-response of exercise blood pressure in aged patients with hypertension.