Study On The Curative Effect Of Quantified Exercise Prescription On Senile Hypertension

Background and ObjectiveHypertension is an important public health problem worldwide and one of the most important variable risk factors for cardiovascular and cerebrovascular diseases.As the most common chronic disease among the elderly clinically,it not only affects the quality of life of the patients,but also brings heavy economic burden to the family and society.The current treatments for hypertension include antihypertensive drugs（pharmacological approaches）and lifestyle changes（behavioral approaches）.The importance of drugs as a first-line method of lowering blood pressure has been widely confirmed in the clinic.However,less than half of hypertensive patients receiving drug treatment have reached the ideal blood pressure level.The most important reason is lack of Treatment compliance and unhealthy lifestyle.Therefore,it is important to further emphasize the treatment and prevention of hypertension by changing behavioral risk factors.Lifestyle changes include smoking cessation and alcohol restriction,reasonable dietary structure,moderate exercise,psychological counseling and weight control.Among them,exercise is the most important,effective and most recommended basic lifestyle therapy for preventing hypertension.Although there is clinical evidence and guidelines showing that exercise can lower blood pressure,most of these studies have assessed the impact of lifestyle and exercise interventions on blood pressure in younger,rather than older patients with hypertension.The cardiorespiratory fitness（CRF）of the elderly gradually declines with age,and the risk of suffering from various diseases and exercise is greater than that of the young and middle-aged.How to formulate an individualized exercise prescription suitable for elderly hypertensive patients to achieve the desired reduction It is still lack of relevant clinical guidelines and evidence.Cardiopulmonary exercise testing（CPET）,as a technical means to evaluate the overall cardiopulmonary function of patients,has been widely used in clinical cardiac rehabilitation treatment.Some studies have shown that the cardiopulmonary exercise testing can safely and effectively reduce the blood pressure of patients by prescribing exercise for hypertensive patients.Based on the above reasons,this study,guided by cardiopulmonary exercise test,evaluated the overall functional status of elderly patients with hypertension,and observed the effects of exercise on their dynamic blood pressure level and cardiopulmonary function,so as to provide a theoretical basis for the further promotion of non-drug therapy for patients with hypertension.Methods:From November 2019 to December 2020,60 inpatients diagnosed with essential hypertension and regularly taking antihypertensive drugs at the Fifth Affiliated Hospital of Zhengzhou University were selected as the research objects,and were randomly divided into the control group and the study group by the digital lottery method,30 people in the control group received only conventional drug treatment,and 30 people in the research group combined individualized sports rehabilitation exercises on the basis of drug treatment.Both groups of patients did not undergo antihypertensive drug regimen adjustments during the study period.All patients were performed before treatment and 12 weeks after treatment related parameters of cardiopulmonary exercise test（including the forced vital capacity（FVC）,the chase volume（MVV is）,peak oxygen uptake（Peak VO₂/Kg）,anaerobic threshold（AT）,maximum metabolic equivalent（max METs）,resting heart rate（HRrest）,resting systolic blood pressure（SBPrest）,resting diastolic blood pressure（DBPrest）,peak heart rate（HRpeak）peak,peak systolic blood pressure（SBPpeak）,diastolic blood pressure（DBPpeak）,maximum power）and dynamic blood pressure（Ambulatory blood pressure（ABP）,including 24h mean systolic blood pressure/diastolic blood pressure（24h MSBP/24h MDBP）,daytime mean systolic blood pressure/diastolic blood pressure（DMSBP/DMDBP）,and night mean systolic blood pressure/diastolic blood pressure（NMSBP/NMDBP））.Results:There was no significant difference in general clinical data such as gender,age,course of disease,blood lipids,blood sugar,height and weight between the two groups of patients,and they were comparable（P>0.05）.Before intervention,there was no significant difference in the indicators of ambulatory blood pressure24h MSBP,24h MDBP,d MSBP,d MDBP,n MSBP,n MDBP between the two groups of patients（P>0.05）;Compared with the pre-intervention,after 12 weeks of exercise intervention in the study group,24h MSBP,24h MDBP,d MSBP,d MDBP,n MSBP,n MDBP all decreased（P<0.05）,and compared with the control group,it was also significantly lower than the control group（P<0.05）).Before the intervention,there was no significant difference in CPET indexes BMI,HRrest,SBPrest,DBPrest,SBPpeak,DBPpeak,max METS,peak VO₂/Kg,maximum power,and HRpeak between the two groups of patients（P>0.05）;After 12 weeks of exercise intervention in the study group,BMI,HRrest,SBPrest,DBPrest,SBPpeak,and DBPpeak were significantly lower than those in the control group（P<0.05）,and max METS,peak VO₂/Kg,maximum power,and HRpeak were significantly higher than those in the control group（P<0.05）.Conclusions:Compared with only relying on antihypertensive drugs,a"tailor-made"exercise and rehabilitation prescription guided by a cardiopulmonary exercise test can more effectively reduce the blood pressure of elderly hypertensive patients and improve their cardiopulmonary function and exercise ability.Conducive to further reducing the incidence of cardiovascular and cerebrovascular events,hospitalization rates and mortality.