Study on the therapeutic effects of individualized exercise prescriptions on hypertension in the elderly / 中华老年医学杂志

ABSTRACT

Objective:To examine the effects of individualized exercise rehabilitation prescriptions based on cardiopulmonary exercise tests on ambulatory blood pressure and cardiopulmonary function in elderly hypertension patients.Methods:This was a prospective randomized controlled study.Sixty essential hypertension patients hospitalized in our hospital from January 2020 to November 2020 and on regular antihypertensive medication were selected and divided using a random number table into the control group(30 cases)and the study group(30 cases). The control group received only conventional medication and the study group conducted individualized exercise rehabilitation in addition to medication, with no adjustment in anti-hypertensive medication for patients in either group.All enrolled patients underwent cardiopulmonary exercise testing and ambulatory blood pressure monitoring before treatment and 12 weeks after treatment.Changes in blood pressure and cardiopulmonary function in the two groups were compared.Results:Compared with the control group, the study group recorded reductions in the 24-hour average systolic blood pressure(135.6±8.7 mmHg vs.141.8±6.3 mmHg), 24-hour average diastolic blood pressure(79.3±9.4 mmHg vs.85.1±6.7 mmHg), daytime average systolic blood pressure(136.4±7.8 mmHg vs.140.2±6.6 mmHg), daytime average diastolic blood pressure(78.2±7.6 mmHg vs.84.4±7.2 mmHg), night-time average systolic blood pressure(125.0±9.6 mmHg vs.129.7±7.9 mmHg), and night-time average diastolic blood pressure(76.6±7.6 mmHg vs.84.5±6.7 mmHg)after 12 weeks of exercise( P<0.05 for all). Compared with pre-exercise levels, the study group achieved decreases in body mass index, resting heart rate, resting systolic blood pressure, resting diastolic blood pressure, peak systolic blood pressure, peak diastolic blood pressure( P<0.05 for all), and increases in maximum metabolic equivalent, peak oxygen uptake, maximum power and peak heart rate( P<0.05 for all), while the control group saw decreases in resting heart rate and resting diastolic blood pressure( P<0.05). After 12 weeks, the study group had lower levels than the control group in body mass index(24.5±2.0 kg/m 2vs.26.7±2.2 kg/m 2), resting systolic blood pressure(133.8±10.8 mmHg vs.139.3±9.0 mmHg)and resting diastolic blood pressure(79.4±8.0 mmHg vs.84.9±9.3 mmHg)( P<0.05)and higher levels in maximum metabolic equivalent(6.0±0.6 vs.5.2±1.1), peak oxygen uptake(22.0±2.7 ml·min -1·kg -1vs.20.3±3.7 ml·min -1·kg -1), maximum power(124.3±19.9 W vs.112.4±25.1 W)and peak heart rate(130.1±15.5 times/min vs.122.9±11.7 times/min)( P<0.05). Conclusions:Compared with antihypertensive drugs alone, the addition of individualized exercise prescriptions for rehabilitation based on cardiopulmonary exercise tests can effectively reduce blood pressure, improve cardiopulmonary function, and enhance exercise endurance and quality of life for elderly hypertension patients.