Correlation Between The Ascending Range Of Blood Pressure Response To Exercise And BPV?arteriosclerosis In The Hypertensive Patients

Objective: Through observing the ascending range of systolic blood pressure response to exercise and the correlation between the ascending range of systolic blood pressure response to exercise,blood pressure variability (BPV) ,brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and arteriosclerosis index (AI) in the hypertensive patients, to discuss the value of blood pressure response to exercise increasing in assessing the prognosis of in the hypertensive patients.Method:Selected a total of 232 subjects(142 males and 90 females) who matched the selective criteria from April 2015 to November 2016 in the outpatients and hospitalized patients of Department of Geriatrics department,Yan'an Hospital,Kunming,including 99 cases of normal blood pressure group, 133 cases of hypertensive group. All the subjects had accomplished the maximal treadmill exercise test according to the Bruce program. The blood pressure were measured before exercise, during exercise and the termination of exercise, then calculated the ascending range of systolic blood pressure response to exercise. According to the ascending range divided into: group A(the ascending range <50% in the normal blood pressure group)55 cases,group B(the ascending range >50% in the normal blood pressure group)44 cases,group C(the ascending range <50% in the hypertensive group)75 cases,group D(the ascending range ? 50% in the hypertensive group)58 cases.All subjects were. accomplished 24-hour ambulatory blood pressure monitoring(ABPM), arteriosclerosis test,biochemical tests (including fasting blood glucose,postprandial blood glucose, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C)) etc. Collected all subjects'general information,including age, sex,smoking history,body mass index (BMI) etc,compared the ascending range of systolic blood pressure response to exercise among the subgroups, the normal blood pressure group (group A+group B ) and the hypertensive group (group C+group D);compared BPV, baPWV, ABI and AI among the subgroups,the multiple linear regression analysis of the ascending range of systolic blood pressure response to exercise with the above factors was carried on.Results: 1. Comparison of basic data: There was no difference in sex ratio (male /female), age,smoking history,BMI,fasting blood glucose,postprandial blood glucose,TG,TC,LDL-C,HDL-C in the subgroups (P> 0.05).2.Comparison of the ascending range of systolic blood pressure response to exercise: group D> group B> group C> group A (P<0.01),the hypertensive group(group C+group D) were higher than the normal blood pressure group (group A+group B ) (P<0.01).3.Comparison of BPV among the subgroups:The BPV of group B?C?D were higher than group A (P<0.05);The BPV of group C?D were higher than group B(P<0.05);The BPV of group D were higher than group C (P<0.05).4.Comparison of baPWV?ABI?AI among the subgroups:The baPWV?AI of group B?C?D were higher than group A,ABI were lower(P < 0.01 );The baPWV?AI of group C?D were higher than group B,ABI were lower(P<0.01);The baPWV?AI of group D were higher than group C,ABI were lower(P<0.01).5.The linear correlation between the ascending range of systolic blood pressure response to exercise and the BPV?baPWV?ABI?AI:The ascending range of systolic blood pressure response to exercise had a positive correlation with BPV?baPWV and AI (P < 0.01 or <0.05), and had a negative correlation with ABI (P <0.41).6.The multiple linear regression analysis between the ascending range of systolic blood pressure response to exercise?BPV?baPWV?ABI?AI and related cardiovascular risk factors:?Normal blood pressure group: The ascending range of systolic blood pressure response to exercise was positively correlated with baPWV(P<0.01), and negatively correlated with HDL-C(P<0.01). ?The hypertensive group:The ascending range of systolic blood pressure response to exercise was positively correlated with baPWV?AI(P<0.01),and negatively correlated with HDL-C (P<0.01).Conclusion: 1.Compared with the normal blood pressure group, the ascending range of systolic blood pressure response to exercise of the hypertensive group was higher, which indicated that the hypertensive patients were more likely to develop exaggrated blood pressure response to exercise.2.The higher ascending range of systolic blood pressure response to exercise was, the greater BPV was,which indicated the serious of autonomic nerve dysfunction,especially in hypertensive patients.3.The higher ascending range of systolic blood pressure response to exercise was, the greater baPWV?AI were,ABI was also lower,which indicated the serious of degree of arteriosclerosis,especially in hypertensive patients.4.The ascending range of systolic blood pressure response to exercise was positively correlated with baPWV,negatively correlated with HDL-C,and also positively correlated with AI in the hypertensive patients.