Визначення толерантності до фізичного навантаження і резервів організму в дітей шкільного віку з ожирінням та артеріальною гіпертензією

Abstract

Determining of tolerance to physical exertion (TPE) in children with various diseases is an important diagnostic aspect of modern medicine. This area helps to improve the prognostic capabilities of doctors and improve approaches to therapeutic interventions in patients with various pathologies. In pediatrics, there are limited data on the study of TPE in patients with hypertension and no data at all in children with a combination of hypertension and obesity. Purpose - to assess the level of TPE and body reserves in school-age children with obesity and arterial hypertension. Materials and methods. 112 patients aged 9-18 took part in the study. All patients were divided into four groups. The Group 1 (control) included children with normal blood pressure and normal body weight; the Group 2 included patients with arterial hypertension and normal body weight; the Group 3 - with normal arterial pressure and obesity; the Group 4 - with a combination of arterial hypertension and obesity. Results and conclusions. If patients have hypertension or obesity, a decrease in VO2max is noted, which is more pronounced when these pathologies are comorbid. Obese boys have a tendency to increase maximum systolic blood pressure during bicycle ergometry (158.2±8.4 mmHg) compared to healthy children (149.4±10.5 mmHg). The average values of maximum diastolic blood pressure during bicycle ergometry in all studied groups did not differ significantly from the average values of the control group. Obesity is accompanied by a more pronounced decrease in vascular reserves than arterial hypertension, the comorbidity of these diseases in patients is associated with the deterioration of these reserves in comparison with patients who have only one disease. The obtained results indicate a decrease in cardiac reserves when the patient has comorbidities of arterial hypertension and obesity. At the same time, the presence of only one of the named diseases in the patient is not accompanied by a significant decrease in indicators compared to the control group. In patients with arterial hypertension, a less effective use of myocardial reserves and an increased demand for myocardial oxygen during work compared to healthy children are noted. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.