[Effect of ambulatory supervised cardiac training on arterial hypertension in patients with coronary artery disease and arterial hypertension].
Arterial hypertension is one of the most common health problems occurring in highly developed countries. It was proved that long-term and regular physical activity results in hypotensive effect.


OBJECTIVE
A goal of the present study was to assess an influence of six-month ambulatory cardiac rehabilitation on arterial pressure level in patients with coronary artery disease and hypertension as well as analysis of correlation between pressure values alterations and intensity of cardiac training.


METHODS
A study group comprised 103 patients (mean age: 61.2 +/- 0.8 years) manifesting coronary artery disease accompanied by arterial hypertension. A control group constituted 39 normotensive patients with coronary artery disease (mean age: 59.4 +/- 1.3 years). The both observed groups differ from each other only with values of left ventricle mass index and drug regimen established at least three months prior to the follow-up onset. During the rehabilitation cycle, no treatment corrections were made and no new preparations were added. The all patients were enrolled to the six-month cardiac rehabilitation program. The program comprised 45-minute training with cycle ergometer, three times a week, and generally improving gym exercises, two times a week. The analyses concerned systolic and diastolic pressure values, measured just before each training (resting pressure) and just after peak exercise interval (peak pressure), at the beginning and at the end of the rehabilitation cycle. At the initial stage, the patient group with hypertension demonstrated the higher pressure values (resting and peak), as compared with the control group.


RESULTS
Cardiac rehabilitation performed in the examined patients caused a statistically significant reduction of the mean resting pressure, both systolic (p < 0.01) and diastolic (p < 0.01). As to the mean peak pressure in this group, systolic diminished slightly (NS), but diastolic was reduced significantly (p < 0.01). In the control group, after six-month rehabilitation the values appeared to be lowered insignificantly in relation to systolic and diastolic resting pressure, likewise diastolic peak pressure, and contrarily systolic peak pressure increased slightly. Assessing an interrelation between the final outcome of the rehabilitation program, expressed as delta of arterial pressure, and terminal training workload and delta of training workload, only for delta of systolic pressure and final training workload, a positive correlation of statistical significance was found out, which is considered an implication of physiological reaction against an increase of training workload.


CONCLUSIONS
Long-term and regular cardiac training induced the larger alterations of pressure values in the patients with hypertension, as compared with the normotensive patients. A positive effect of cardiac rehabilitation on arterial pressure level in the hypertensive patients was found to be independent of the training intensity.
Kałka
Dariusz
D
Department of Cardiac Rehabilitation, Medicine and Rehabilitation Center "Medar", Wrocław, Poland.
Sobieszczańska
Małgorzata
M
Marciniak
Wojciech
W
Popielewicz-Kautz
Aleksandra
A
Markuszewski
Leszek
L
Chorebała
Arkadiusz
A
Korzeniowska
Joanna
J
Janczak
Jacek
J
Adamus
Jerzy
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D003324:Coronary Artery Disease / Q000150:complications* / Q000517:prevention & control*; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010807:Physical Endurance / Q000502:physiology; D012016:Reference Values; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents