Unit:
Κατεύθυνση Μονάδες Εντατικής Θεραπείας-Καρδιολογική ΝοσηλευτικήLibrary of the School of Health Sciences
Author:
Dimitrakopoulou Maria
Supervisors info:
Τσιάμης Ελευθέριος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Κυρίτση Ελένη, Ομότιμη Καθηγήτρια, Νοσηλευτική, Πανεπιστήμιο Δυτικής Αττικής
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Ο ρόλος της μεταβολής της αρτηριακής πίεσης και του ρυθμού αποκατάστασής της κατά τη δοκιμασία κόπωσης στη 10ετη εμφάνιση θανατηφόρων και μη καρδιαγγειακών συμβαμάτων
Translated title:
The role of blood pressure changes during the cardiac stress test and the immediate recovery period in the prediction of adverse cardiovascular outcomes for 10 years of follow-up
Summary:
Introduction: The stress test is a non-invasive diagnostic procedure for the diagnosis of coronary artery disease in high-risk individuals. Its interpretation is based on emergent angina or electrocardiographic abnormalities indicative of myocardial ischemia during exercise. Blood pressure is routinely measured at standard intervals during the test, but the prognostic significance of blood pressure changes during the cardiac stress test has yet to be clearly elucidated. An increase in blood pressure during exercise is considered a normal response, but an association between exaggerated or severely diminished hypertensive responses to exercise with an increased risk of adverse outcomes has been documented in the literature.
Aim: The purpose of this study is to investigate whether blood pressure changes during the stress test differ between hypertensive or normotensive individuals and evaluate whether they are predictive of cardiovascular events during a 10-year follow-up period.
Material and Method: The sample of the study consisted of 236 adult patients who were referred to the Hippocratic Hospital from 2009 to 2018 for a cardiac stress test. The stress test was performed by a modified Bruce protocol and blood pressure measurements were made per minute for the first 5 minutes of exercise and the first 5 minutes of recovery. The statistical analysis of the data was done in the SPSS program, with t-test for independent samples for comparison in continuous variables and with x2 test for discrete variables.
Results: Of the 236 patients, 114 had hypertension and 16 had serious cardiovascular pathology. There was statistically significant correlation between the change in pressure in the 3rd minute exercise with the risk of cardiovascular events (p = 0.044). Hypertensive subjects had higher peak blood pressure (p <0.001), and double-blinded at 1 (p = 0.027), as well as a larger double product at the 2nd minute of recovery (p = 0.012). The normotensive subjects were younger (p <0.001) and had a higher blood pressure increase in the first minute of exercise (p = 0.027) and higher maximum heart rate (p <0.001).
Conclusions: A rapid increase of blood pressure during exercise may be associated with an increased risk for adverse cardiovascular outcomes and further research is required to evaluate this hypothesis. Hypertension may lead to a greater in absolute terms, slower and longer lasting increase in blood pressure during exercise, but due to the confounding effects of age in this sample this claim could not be adequately assessed in our study.
Main subject category:
Health Sciences
Keywords:
Blood pressure, Cardiac stress test, Cardiovascular outcomes
Number of references:
113
