Chinese General Practice ›› 2016, Vol. 19 ›› Issue (35): 4316-4322.DOI: 10.3969/j.issn.1007-9572.2016.35.006

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Effects of CPET-based Precise Formulation of Individualized Moderate-intensity Exercise Prescription on Hypertension

  

  1. National Center for Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Disease Clinical Medicine Research,Beijing 100037,China Corresponding author:SUN Xing-guo,National Center for Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Disease Clinical Medicine Research,Beijing 100037,China;Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China;E-mail:xgsun@labiomed.org
  • Published:2016-12-15 Online:2026-01-28

心肺运动试验精准制定个体化适度强度运动康复处方治疗高血压的疗效研究

  

  1. 100037北京市,国家心血管病中心 中国医学科学院阜外医院 北京协和医学院 心血管疾病国家重点实验室 国家心血管疾病临床医学研究中心(葛万刚,孙兴国);首都医科大学附属北京康复医院(孙兴国,刘艳玲,冯静,席家宁,张振英) 通信作者:孙兴国,100037北京市,国家心血管病中心 中国医学科学院阜外医院 北京协和医学院 心血管疾病国家重点实验室 国家心血管疾病临床医学研究中心,首都医科大学附属北京康复医院;E-mail:xgsun@labiomed.org
  • 基金资助:
    国家高技术研究发展计划(863计划)课题(2012AA021009);国家自然科学基金医学科学部面上项目(81470204);中国医学科学院国家心血管病中心阜外医院科研开发启动基金(2012-YJR02);首都临床特色应用研究(Z141107002514084);首都临床特色应用研究与成果推广(Z161100000516127)

Abstract: Objective Cardiopulmonary exercise testing(CPET) was used to evaluate the overall function objectively and quantitatively in this study,and based on the results,an individualized moderate intensity exercise prescription was formulated precisely.The aim of this study was to investigate the effects of individualized moderate-intensity exercise prescription with holistic rehabilitation protocols on hypertension.Methods From Beijing Rehabilitation Hospital of Capital Medical University,we recruited 5 medical workers with confirmed hypertension and administration of anti-hypertensive drugs to perform symptom-limited extreme CPET.According to the data of CPET,an individualized moderate-intensity exercise training protocol with watts between anaerobic threshold and peak was designed,and patients were treated with the overall rehabilitation program including the optimization of drugs,mental and psychological management,living habits,smoking and alcohol restrictions.Blood pressure was continuously monitored during exercise training.Resting blood pressure was measured before and after exercise,respectively.Patients did daily exercise training for 12 weeks,and medication was adjusted according to the stable level of blood pressure during the training period.Results Patients with hypertension were treated with at least one antihypertensive drug before exercise,then they gradually stopped taking antihypertensive drugs after exercise therapy,and all of them did not take any antihypertensive drugs by the twelfth weeks of exercise therapy.Compared with before exercise training,the SBP of the patients after exercise training was much lower〔(116±10) mm Hg vs.(125±11) mm Hg,1 mm Hg=0.133 kPa,P<0.05〕,and so was the DBP〔(71±7) mm Hg vs. (74±8) mm Hg,P<0.05〕.The resting SBP of the patients before exercise training at the twelfth weeks of exercise therapy was significantly lower than that at the first week(P<0.05).There was no significant difference in the resting SBP of the patients after exercise training between the first and twelfth weeks of exercise therapy(P>0.05).The resting DBP of the patients before or after exercise training demonstrated no statistically significant difference between the first and twelfth weeks of exercise therapy(P>0.05).Conclusion For patients with hypertension,holistic rehabilitation protocols centered on individualized moderate-intensity exercise prescription precisely designed on the basis of overall function evaluated by CPET objectively and quantitatively,can obtain an amazing effect of decreasing the blood pressure,and the blood pressure still remains stable after stopping taking drugs.It is worth doing an advanced study among more patients in the future

Key words: Hypertension, Cardiopulmonary exercise testing, Rehabilitation, Treatment outcome

摘要: 目的 探讨运用心肺运动试验(CPET)进行客观定量整体功能评估,精准制定个体化适度强度运动康复处方治疗高血压的疗效。方法 2015年4—7月招募在首都医科大学附属北京康复医院工作、确诊高血压、服用降压药物治疗的5例医务工作者,采用CPET检查结果计算无氧阈功率,进而精准制定个体化适度强度负荷功率的运动康复处方,并配合优化药物、精神心理方面、生活习惯及禁烟限酒等整体康复方案。患者CPET过程中连续监测血压,每天运动康复前、后分别测定静息血压,坚持运动康复12周,期间根据血压调整药物。结果 高血压患者运动康复前均服用至少一种降压药物,运动康复开始后逐渐停用降压药物,至运动康复第12周均未服用降压药物。患者运动康复后收缩压(SBP)〔(116±10)mm Hg(1 mm Hg=0.133 kPa)与(125±11)mm Hg〕、舒张压(DBP)〔(71±7)mm Hg与(74±8)mm Hg〕均较运动康复前降低(P<0.05)。运动康复第12周时运动康复前静息SBP较运动康复第1周时降低(P<0.05);运动康复第1周与第12周运动康复后静息SBP、运动康复前后静息DBP比较,差异均无统计学意义(P>0.05)。结论 运用CPET客观定量评估整体功能,精准制定个体化适度强度运动康复处方为核心的整体康复方案治疗高血压患者,可有效降低血压并停药后仍然维持血压稳定。值得进一步扩大病例数深入研究。

关键词: 高血压, 心肺运动试验, 康复, 治疗结果