高血压病患者运动血压与动态血压关系的研究

A study of relationship between blood pressure response to exercise and ambulatory blood pressure monitoring in patients with essential hypertension

目的 探讨高血压病患者运动血压与动态血压的关系。方法 分别以活动平板运动试验中最大运动量时收缩压 (peakSBP)和舒张压 (peakDBP)过度升高和反应正常分组 ,以运动后收缩压(recSBP)和舒张压 (recDBP)恢复慢和恢复正常分组 ,对比分析 30 3例 1、2级高血压病患者的动态血压变化。结果 peakSBP、peakDBP过度升高组动态血压各检测值均显著高于反应正常组 (P <0 0 5或0 0 1) ;recSBP恢复慢组的夜间平均收缩压、舒张压显著高于恢复正常组 (P <0 0 1) ;recDBP恢复慢组白昼舒张压负荷显著高于恢复正常组 (P <0 0 1)。多元逐步回归分析显示 ,对peakSBP、peakDBP、recSBP最具影响的共同参数为夜间平均舒张压。结论 高血压病患者运动试验中 74 2 6 %～ 81 85 %存在运动中血压过度升高和运动后收缩压恢复慢并与动态血压检测值有显著统计意义。

Objective To investigate the relationship between blood pressure (BP) response to exercise and ambulatory BP monitoring in patients with essential hypertension. Methods We measured ambulatory BP monitoring in 303 patients with hypertension (stage 1 and 2). Based on the systolic BP (peak SBP) and diastolic BP(peakDBP) response to the maximal exercise during treadmill test, the patients were divided into exaggerated and normal BP response groups. Furthermore, the patients were divided into delayed and normal recovery groups based on recovery SBP(recSBP) and recovery DBP( recDBP) post treadmill test, respectively. Results Ambulatory BP monitoring parameters in the groups of exaggerated peakSBP or peakDBP were significantly higher than those of control group ( P <0.05 or 0.01). Mean BP during nighttime and DBP in the group of delayed recSBP were significantly higher than those of normal recovery group ( P <0.01). DBP during daytime in the group of delayed recDBP was significantly higher than those of normal recovery group ( P <0.01). Mean BP during nighttime was the most powerful influent parameter to peakSBP, PeakDBP and recSBP, according to the multivariable stepwise regression analysis. Conclusion Exaggerated BP response and delayed recSBP to exercise test were existed in about 74.26%-81.85% of patients with essential hypertension. Delayed SBP post exercise was correlated significantly with ambulatory blood pressure monitoring.