The Study Of Individualized Exercise To Effectively Treat Hypertension And The Application Of Beat-by-pulse Blood Pressure Monitoring In Clinical Practice

Objective:Using symptom-limited maximal cardiopulmonary exercise testing(CPET)to precisely design personalized moderate-intensity exercise protocol with holistic integrative rehabilitation to effectively treat hypertension.Methods:We selected five patients with stable hypertension performed CPET.According to the data of CPET,we design moderate-intensity exercise training protocol with watts between anaerobic threshold and peak,and with the auxiliary exercise,optimization of drugs,mental and psychological habits,sleep management,smoking and alcohol restrictions of the overall rehabilitation program.We continuously monitored blood pressure,ECG,heart rate and oxygen saturation during exercise training for safety.Patients did daily 30min high intensity exercise training 5 days a week for 12 weeks,resting blood pressure were measured before and after exercise every day,adjusted medication according to the stable level of blood pressure.We focused on analysis for changes in resting blood pressure before and after exercise and the first and twelfth week.Results:Hypertensive were taken at least one antihypertensive drugs before exercise therapy,all of them phase-out antihypertensive drugs after exercise therapy 2 to 6 weeks.The SBP[(125±11)mm Hg vs(116±10)mm Hg]and DBP[(74±8)mm Hg vs(71±7)mm Hg]after exercise training of the patients were lower than those before exercise training(P<0.05).The resting SBP before exercise training on twelfth week were lower than those on first week[the first week(127±8)mm Hg vs the twelfth(121±9)mm Hg](P<0.05),although the twelfth week had been reduced or disable antihypertensive drugs for more than 6 weeks;The resting SBP after exercise training,the resting DBP before and after exercise training on twelfth week were not significantly different from those on first week(P>0.05).Conclusion:Using the precisely designed personalize moderate-intensity exercise protocol with holistic integrative rehabilitation can obtain an amazing effect of decreasing the resting blood pressure.And more,blood pressure still remained stable after stopped drugs more than one month.It is worth doing an advanced study in the future.Objective:This paper mainly aimed to observe on the highest blood pressure of cardiopulmonary exercise testing(CPET),and to explore that whether blood pressure can be regarded as an indication of termination of CPET based on continuous pressure monitored by the noninvasive method CPET in comparison with traditional cuff pressure.Methods:Six healthy volunteers participated in the CPET using continuous non-invasive blood pressure monitoring instrument in Fuwai hospital during Aug.2016 to Oct.2016.We did statistical analysis Cuff intermittent pressure and continuous beat to beat blood pressure values in different stages.Results:The highest blood pressures of two volunteers exceeded 250mmHg,while it was measured at 187mmHg using the cuff intermittent pressure.Systolic blood pressure of cuff pressure had significant difference in comparison with continuous pressure during warm-up(103±8mmHg vs 109±6mmHg p<0.05)and at 5min during recovery(117±15 mmHg vs 124±16 mmHg,p<0.05).Diastolic blood pressure of cuff pressure had significant difference in comparison with continuous pressure at 2min(64±6mmHg vs 79±8mmHg p<0.05)and at 5min during recovery(59±8 mmHg vs 75±11 mmHg,p<0.05).Conclusions:It is better to show the continuous state of blood pressure and limiting value using continuous pressure.Meanwhile,during the symptom limited CPET,the special highest blood pressure can be not totally regarded as the indication for stopping CPET.