Abstract
Objective: To evaluate different antihypertensive drug regimens for the control of BP according to selected variables of the exercise stress test during cardiac rehabilitation Design and method: Observational, longitudinal, retrospective study in 419 debutant or uncontrolled hypertensive patients, between 18–87 years, treated at ‘El Instituto del Corazón de Querétaro’, from January 2015-December 2021, to which a stress test was performed. The statistical analysis was performed using the statistical software SPSS, Version 28.0.1.0, the comparison of the means between groups was made using the one-way analysis of variance (ANOVA) test. Three variables were considered to evaluate the response to exercise in blood pressure; the blood pressor response to exercise (hypertensive > 10, 7 -10 as normal, 0–7 as flat and < 0 as hypotensive), BP index (>1.22 were taken as normal) and recovery of systolic blood pressure (normal < 0.95) Results: When analyzing 75.5% were men and 24.5% were women, under hypertensive treatment includes Beta blockers (BB), calcium channel blocker (CCBs), angiotensin-converting enzyme (ACE) inhibitors, Angiotensin receptor blockers (ARBs), Loop diuretics and mineralocorticoid receptor antagonist (MCRA). There was no significant difference in the pressor response under any antihypertensive treatment in monotherapy, however a better response was found in the BP index to exercise. In patients with two or more antihypertensive drugs, it was found a better response to the combined treatment with ARBs + MCRA, in the three variables evaluated Conclusions: The exercise stress test may represent a unique tool to assess the effective protection potential of drugs against an important increase in SBP in patients with hypertension during physical activity. The study design elements proposed have the potential to establish exercise testing as a valid tool to assess the efficacy of antihypertensive treatments during stress conditions. Cardiac rehabilitation can significantly improve the parameters assessed in the stress test. It will be useful to compare these data with a short- and long-term stress test and thus evaluate the effectiveness of antihypertensive therapy.
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