The data demonstrate that long-term aerobic exercise is associated with a decrease in BP at rest and during exercise, which is comparable to that of drug therapies. This antihypertensive effect of regular training can be maintained as long as 3 yr.

The blood pressure behavior during and after ergometric exercise was investigated in 552 males in order to clarify if this standardized procedure is suitable for differentiating between normotensive subjects and hypertensive patients. Patients suffering from mild hypertension showed significantly (p < 0.001) higher blood pressures (213 ± 22/116 ± 11 mm Hg) at 100 W and after loading than age-matched normotensives (188 ± 14/92 ± 9 mm Hg) but significantly (p < 0.001) lower values than hypertensives with stable hypertension (225 ± 22/126 ± 11 mm Hg). Moreover, the systolic pressure response to ergometric work was significantly (p < 0.05 – p < 0.01) influenced by age. Using the normal upper limits for blood pressure during and after ergometry the ergometric procedure revealed that 50% of the patients with borderline hypertension at rest could be classified as hypertensives. Their blood pressure response at 100 W (216 ± 21/113 ± 8 mm Hg) did not significantly differ from the patients with mild hypertension. In contrast, in the 50% who reacted negatively to ergometric testing, the systolic blood pressure response at 100 W (204 ± 18 mm Hg) was significantly (p < 0.01) lower than that of those who demonstrated a positive reaction, revealing exactly the same diastolic blood pressure value of 92 mm Hg as the normotensives. The present study strongly suggests that the assessment of blood pressure during ergometric testing is quite useful in distinguishing between normotensive and hypertensive patients and in making estimates of blood pressure response to daily stress more accurate.

The aim of the study was to investigate the pulmonary vasodilator effect of the dihydropyridine calcium channel blocker amlodipine in patients with clinically stable chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH). Many patients with COPD develop chronic PH and this may predict mortality in this disorder. The treatment with calcium channel blockers is accepted as a therapeutic strategy for primary pulmonary hypertension. In twenty male patients (mean age 57+/-7 years) with clinically stable COPD and PH, we investigated whether amlodipine could effectively decrease pulmonary vascular resistance (PVR) and pulmonary arterial pressure (PAP) and improve right heart function. PAP was recorded by a balloon-tipped thermodilution catheter and cardiac output was determined in triplicate by thermodilution at rest and during exercise. In addition, blood gas values were determined from the capillary blood of the earlobe. All measurements were done under identical conditions before and after 18 days of chronic treatment: with 10 mg amlodipine once daily starting with 5mg in the first week. At a mean maximal achieved workload of 71.3+/-20 Watts, amlodipine achieved a significant reduction in PVR (-13.4%; p<0.01) and PAP (-12.1%; p<0.001) implying an improved right heart function assessed by a significant reduction in mean right atrial pressure (-20.6%; p<0.05). During the action of amlodipine there were no significant changes in pulmonary gas exchange and pulmonary capillary wedge pressure. Amlodipine given as a single daily oral dose of 10mg is a safe and effective pulmonary vasodilator in COPD patients with PH and leads to an improvement in right heart function.

No abstract

No abstract