Blood pressure in patients with intermittent claudication increases continuously during walking
Blood pressure in patients with intermittent claudication increases continuously during walking
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DOI：
10.1016/j.ejvs.2006.06.023
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发表时间：
2007-01-01
影响因子：
5.7
通讯作者：
Stranden, E.
中科院分区：
文献类型：
--
作者：
Bakke, E. F.;Hisdal, J.;Stranden, E.
目标。本研究的目的是比较外周动脉粥样硬化性疾病(PAD)患者和健康对照组对步行的循环反应。参与者是11名确诊为PAD的患者，以及6名年龄匹配的健康成年人作为对照组。在步行前、中、后连续记录血压、心率和肢端皮肤灌注量。患者在跑步机上步行至最大跛行距离(MCD)，中位步行距离103(34~223)m[中位(范围)]，速度3.3(1.0~4.5)km/h。跛行时平均动脉压升高46.6(10.3~61.3)mm Hg，收缩压升高84.9(31.4~124.9)mm Hg，舒张压升高2 1.7(-2.1~31.7)mm Hg。心率增加34.9(12.9-48.1)次/分。对照组以3.2(3.0-3.3)km/h的速度步行5分钟。对照组的血压起初呈中度升高，但随后趋于稳定。步行时MAP中位数升高8.5(5.6~14.6)mm Hg，SP升高30.9(6.6~41.5)mm Hg，DP降低-1.4(-5.4~1.5)mm Hg。心率增加27.1(18.8-34.9)次/分。我们发现在步行运动中，患者和对照组之间的肢端皮肤灌注量没有显著差异。在PAD患者中，当步行至MCD(动态运动)时，血压持续显著升高。血压升高的程度与等长运动引起的相似。
Objectives. The purpose of this study was to compare the circulatory responses to walking in patients with peripheral atherosclerotic disease (PAD) and healthy controls.Methods. The participants were eleven patients with diagnosed PAD, and a control group of six healthy age-matched adults. Blood pressure, heart rate (HR), and acral skin Perfusion were recorded continuously before, during and after a walking exercise on a treadmill.Results. The patients walked to maximum claudication distance (MCD) on a treadmill, median walking distance 103 (34-223) metres [median (range)], at 3.3 (1.0-4.5) km/h. There was a steep increase in HR and mean arterial pressure (MAP) while the patients were walking. At claudication the median rise in MAP was 46.6 (10.3-61.3) mmHg, systolic blood pressure (SP) increased by 84.9 (31.4-124.9) mmHg, and diastolic blood pressure (DP) by 21.7 (-2.1-31.7) mmHg. HR increased by 34.9 (12.9-48.1) beats/min. The control group walked for 5 minutes at 3.2 (3.0-3.3) km/h. In the control group the blood pressure initially increased moderately but stabilised thereafter. Median rise in MAP during walking was 8.5 (5.6-14.6) mmHg, SP increased by 30.9 (6.6-41.5) mmHg, and DP was reduced by -1.4 (-5.4-1.5) mmHg. HR increased by 27.1 (18.8-34.9) beats/min. We found no significant differences in acral skin perfusion during walking exercise between the patients and control group.Conclusions. In patients with PAD, blood pressure increased continuously and significantly when walking to MCD (dynamic exercise). The level of increase in blood pressure was similar to that caused in response to isometric exercise.