LONG-TERM PHYSICAL TRAINING IN HYPERTENSIVE PATIENTS: PREDICTION OF EFFICACY

Objective. To assess the efficacy of physical exercise program in hypertensive patients with the use of physical exercise tolerance test and post-test heart rate restoration. design ant methods. We examined 57 patients [median aged 63 (56, 67) years old] with the II–III stage hypertension and achieved target blood pressure. All of them were included in the regular physical exercises program for 1 academic year (9 months). Bicycle ergometry was performed before the beginning of the training and in the end of the academic year, the heart rate restoration during 5 minutes after the physical load was assessed. It was determined as difference between the threshold of heart rate restoration and heart rate restoration in the end of each minute. At baseline, all patients were divided into 2 subgroups: group with “rapid” (1st group) and “slow” (2nd group) restoration after bicycle ergometry. Results. Discriminative analysis provided the formula for predicting the efficacy of standard programs of rehabilitation in hypertensive patients. conclusions. Follow-up examination (at the end of rehabilitation course) demonstrated significant improvement in patients with initial high heart rate restoration after the bicycle ergometry. Among those with low heart rate restoration after bicycle ergometry, no improvement was noted in 73 % cases. We believe that these patients require an individual approach and other types of exercise testing.

heart rate restoration, graduated physical exercise, hypertension, long-term exercise

1. Иванова О. А., Куклин С. Г. Толерантность к физической нагрузке, структура сердечного ритма и артериальное давление у пожилых женщин перед началом периода физической реабилитации в группах здоровья. Сибирский медицинский журнал. 2015;133(2):52–55. [Ivanova OA, Kuklin SG. Exercise tolerance, structure, heart rate and blood pressure in older women before rehabilitation period in the health group. Siberian Medical Journal. 2012;133(2):52–55. In Russian].

2. Иванова О. А., Куклин С. Г. Реакция ритма сердца на этапах тренировочной нагрузки при физической реабилитации у кардиологических больных. Сибирский медицинский журнал. 2012;113(6):33–35. [Ivanova OA, Kuklin SG. Response to training heart rate load in physical rehabilitation in cardiac patients. Siberian Medical Journal.2012;113(6):33–35. In Russian].

3. Иванова О. А., Куклин С. Г. Динамика реактивности структуры сердечного ритма у больных артериальной гипертонией и ишемической болезнью сердца на поликлиническом этапе физической реабилитации. Международная научнопрактическая конференция Восток–Россия–Запад «Современные проблемы и инновационные технологии в развитии физической культуры и спорта». 2011;2:164–169. [Ivanova OA, Kuklin SG. Dynamics in the reactivity of heart rhythm in patients with arterial hypertension and coronary heart disease during the out-patient rehabilitation. International Conference “East–Russia– West”: “Modern problems and innovations in the development of physical culture and sports”. 2011;2:164–169. In Russian].

4. Патент РФ на изобретение № 2592249/29.05.2015, МПК А 61 В 5/00, 5/02. Шушунова О. В., Архипов О. Г., Архипова Л. Н. Способ прогнозирования эффективности физической реабилитации у больных артериальной гипертензией. Доступно по: http://www1.fips.ru/wps/portal/IPS_ Ru#1475560010359. Ссылка активна на 10.10.2016. [Patent RUS № 2592249/29.05.2015, MPK A 61 V 5/00, 5/02. Shushunova OV, Arkhipov OG, Arkhipova LN. A method for prediction of physical rehabilitation in hypertensive patients. Available at: http://www1. fips.ru/wps/portal/IPS_Ru#1475560010359. Access: 10.10.2016. In Russian].

5. Головунина Е. С., Мухарлямов Ф. Ю., Рассулова М. А., Иванова Е. С. Применение циклических и силовых нагрузок при гипертонической болезни. Кардиоваскулярная терапия и профилактика. 2012;11(6):4–8. [Golovunina ES, Mukharlyamov FY, Rassulova MA, Ivanova ES. Multiple-set resistance exercise in essential arterial hypertension. Cardiovascular Therapy and Prevention. 2012;11(6):4–8. In Russian].

6. Сивохов В. Л., Сивохова Е. Л., Иванова О. А., Кириллов Ю. К. Использование инновационных технологий в медикобиологическом обеспечении физической культуры и спорта. Монография. Иркутск. 2016:36–37. [Sivokhov VL, Sivokhova EL, Ivanova OA, Kirillov YK. Innovative technologies in medical and biological provisions of physical culture and sport. 2016:36–37. In Russian].

7. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate Recovery Immediately after Exercise as a Predictor of Mortality. N Engl J Med. 1999;341(18):1351–1357.

8. Рекомендации по лечению артериальной гипертонии ESH/ESC 2013. Российский кардиологический журнал. 2014;1 (105):7–94. [Guidelines on the management of arterial hypertension ESH/ESC-2013. Russian Journal of Cardiology. 2014;1(105):7–94. In Russian].

9. Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J. Exercise Standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104(14):1694–1740.