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1、Therapeuticroleofexercise intreatinghypertensionDalynnT.Badenhop,Ph.D.,FACSMProfessorofMedicineDirector,CardiacRehabilitationMedicalCollegeofOhioEducationalObjectivesToexplaintheacutebloodpressureresponsetoexerciseTolistthemechanismsbywhichexercisemayim
2、provehypertensionToapplyexerciseguidelinesintreatinghypertensionToprescribeappropriatedrugtherapyforactivehypertensivepatientsOverviewofHypertensionHighBPisariskfactorforstroke,CHF,angina,renalfailure,LVHandMIHypertensionclusterswithhyperlipidemia,diabe
3、tesandobesityDrugshavebeeneffectiveintreatinghighBPbutbecauseoftheirsideeffectsandcost,non-pharmacologicalternativesareattractive1997JNCVIClassificationofBloodPressureBloodPressureCategorySystolicDiastolicOptimal<120<80Normal<130<85HighNormal130-13985-8
4、9HypertensionStage1(Mild)140-15990-99Stage2(Moderate)160-179100-109Stage3(Severe)>180>110OverviewofHypertensionJointNationalCommitteeVI(JNCVI)onPrevention,Detection,Evaluation,andTreatmentofHighBloodPressure(1997)50millionhypertensivepatientsintheU.S.Na
5、tionalHealthandNutritionExaminationSurveyIII(NHANESIII)(1995)only21%oftreatedhypertensivepatientshaveBPcontrolledto<140/90mmHg35%ofhypertensivepatientsareunawareoftheirconditionHigh-normalBPisassociatedwithanincresedriskofcardiovasculardiseaseNEngJMed20
6、01;345;1291-7PathophysiologyofHypertensionEssentialhypertensionischaracterizedbyincreasedDBPandrelatedarteriolarvasoconstrictionleadingtoincreasedSBPBPismainlydeterminedbycardiacoutputandtotalperipheralresistanceHighbloodpressuremaybelinkedtoage-related
7、vascularstiffeningPathophysiologyofHypertensionHighbloodpressureisalsoassociatedwithobesity,saltintake,lowpotassiumintake,physicalinactivity,heavyalcoholuseandpsychologicalstressIntra-abdominalfatandhyperinsulinemiamayplayaroleinthepathogenesisofhyperte
8、nsionPrevalenceofOtherRiskFactorsWithHypertensionRiskFactorPercentSmoking35LDLCholesterol>140mg/dl40HDLCholesterol<40mg/dl25Obesity40Diabetes15Hyperinsulinemia50Sedentarylifestyle>50KaplanNM.DisMon1992;38:769-838CardiovascularCon
