| Objective:To explore the influencing factors of exercise-induced hypertension and the damage of heart,brain,kidney and other target organs.Methods:A retrospective analysis was made of the patients with mild to moderate hypertension who completed the treadmill exercise test in our hospital from June 2016 to April 2017.According to the changes of blood pressure in the treadmill exercise test,the patients were divided into two groups: the non-exercise hypertension group and the exercise hypertension group(That is to say,systolic blood pressure during male exercise-systolic blood pressure at rest ? 60 mmHg or systolic blood pressure during female exercise-systolic blood pressure at rest?50mmHg).All patients' gender,age,body mass index(BMI),family history of hypertension,history of coronary heart disease,homocysteine,blood glucose,blood lipid,C-reactive protein(CRP)and other relevant datawere collected.The general data and biochemical data of the patients were analyzed by single factor analysis,and the factors with significant differences were included in the multivariate logistic regression analysis,to explore the influencing factors of exercise-induced hypertension in the treadmill exercise test of the patients with hypertension;The results of renal function,color Doppler ultrasound of heart,color Dopplerultrasound of neck blood vessels,CT or MRI were collected from the two groups,and the selected patients were followed up for 20.6±2.9 months to observe the changes of the corresponding indicators of target organs,and to study the damage of heart,brain,kidney and other target organs before and after the follow-up.Results:1.152 patients with mild to moderate hypertension were divided into non-exercising hypertension group and exercising hypertension group according to the degree of blood pressure change during exercise.The general data and biochemical data of the two groups were analyzed by the single factor analysis.The body mass index,triglyceride,LDL-Cand C-reactive protein in the exercise-induced hypertension group were significantly higher than those in the non exercise-induced hypertension group(P<0.05),while HDL-C was significantly lower than those in the non exercise-induced hypertension group(P<0.01).2.The results of multivariate binary logistic regression analysis showed that body mass index(OR=1.274,95%CI:1.029-1.577,P=0.026),glycerin three lipids(OR=1.507,95%CI:1.052-2.158,P=0.025),C reactive protein(OR=1.4,95%CI:1.083-1.810,P=0.010)were the risk factors of exercise induced hypertension in patients with hypertension.High density lipoprotein cholesterol(OR=0.414,95% CI:0.233-0.734,P=0.003)is the protective factor for exercise hypertension in patients with hypertension.3.In terms of the target organ damage of hypertension,before and after follow-up,the decrease of glomerular filtration rate in the exercise-induced hypertension group was significantly higher than that in thenon exercise-induced hypertension group,and the increase of left ventricular mass index(LVMI)and carotid intima-media thickness(IMT)was significantly higher than that in the non exercise induced hypertension group(P<0.05).Before the follow-up,there was no statistically significant difference in the occurrence of lacunar cerebral infarction between the two groups(P>0.05);while during the follow-up,the occurrence ofcerebrovascular events in patients with exercise hypertension wassignificantly higher than that in patients with non exercise hypertension(P<0.05).4.The systolic blood pressure in both groups fluctuated significantly with time during exercise,and the systolic blood pressure at the laststage of exercise was significantly higher than that in the rest,the first stage of exercise and the second minute of recovery(P<0.01);the diastolic blood pressure in the last stage of exercise was significantly higher than that in the rest(P<0.05),but there was no significant difference compared with that in the first stage of exercise and the second minute of recovery.During the whole exercise,systolic blood pressurechanged more significantly than diastolic blood pressure.Conclusions:1.C-reactive protein,body mass index and triglyceride are the risk factors for exercise hypertension in patients with hypertension,while HDL is the protective factor.2.Compared with patients in the non-exercise hypertension group,patients in the exercise hypertension group suffered more severe damage to their target organs such as heart,brain,kidney,etc,suggesting that exercise hypertension was related to the increase of the target organ damage tendency. |
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