Korzystny wpływ terapii hipotensyjnej na zdolność do wykonania wysiłku ocenianą w 6-minutowym teście marszowym w obserwacji rocznej

Abstract

Introduction. Individual variation of exercise tolerance may be clinically important even in asymptomatic patients with arterial hypertension (HTN). The aim of the study was to evaluate the effect of antihypertensive therapy on exercise capacity assessed by a 6-minute walk test (6-MWT) and its relation to selected clinical and hemodynamic parameters. Material and methods. In a group of 111 hypertensive patients without symptoms of heart failure, the change in 6-MWT distance (d_6-MWT) after 12 months of antihypertensive therapy was assessed in relation to their clinical status and hemodynamic parameters, assessed by echocardiography, impedance cardiography, and applanation tonometry. Results. In the overall study group, antihypertensive therapy was associated with a significant increase in the mean d_6-MWT (592.9 ± 72.8 vs 613.4 ± 66.0 m, P = 0.030). The change in d_6-MWT depended on baseline values, with the most significant improvement (mean by 63.4 m) observed in patients with initially lowest d_6-MWT (bottom quartile, < 530 m). No statistically significant correlations were found between d_6-MWT and changes in clinical and hemodynamic parameters. However, trends were noted towards positive associations between d_6-MWT and an echocardiographic indicator of left ventricular filling pressure (E/e’), left ventricular ejection fraction, and stroke index. Conclusions. Antihypertensive therapy improves exercise capacity in hypertensives with initially reduced exercise capacity, and this effect may be related to positive changes in the left ventricular systolic and diastolic function.