| Abstrakt: |
Isometric (ISO) and dynamic (DYN) exercise stress tests were performed on 91 hypertensive and 42 normotensive control subjects 14-17 years old. The hypertensives had resting systolic or diastolic pressures persistently = 95th percentile. Blood pressure and Frank VCG were recorded during ISO handgrip (25% of maximum effort for 4 minutes) and bicycle ergometry until the subject was exhausted. At peak DYN exercise, heart rates averaged 191±12 (SD) bpm, and oxygen consumption 34±10 cc/min/kg, indicating near-maximal performance was achieved in most subjects. In the hypertensives, blood pressures (mm Hg) averaged 133±11/77±9 at rest, 148±13/92±12 during ISO stress, and 186±21/68±21 during peak DYN stress. In controls, pressures averaged 110±7/62±12 at rest, 129±11/81±8 during ISO stress, and 166±18/63±14 during peak DYN stress. During DYN stress, 34% of the hypertensives and 5% of the controls had systolic pressures =200, however, only 1 hypertensive exceeded 220. During ISO stress, 8% of the hypertensives and none of the controls had diastolic pressures =110; only 1 hypertensive exceeded 120. No adolescent developed cardiovascular symptoms, arrhythmias, or ST segment displacement greater than 1 mm. In view of these findings, we feel hypertensive adolescents should not be restricted in their physical activities unless abnormal cardiovascular changes have been demonstrated during exercise stress testing. |
