Tolerância ao esforço de hipertensos em tratamento farmacológico

Abstract

The systemic hypertension is a disease with high prevalence and the major cause of cardiovascular morbid-mortality. Among the therapeutic measuresrecommendedare the modificationoflifestyle andregularphysical activity. It is knownthat someantihypertensive drugshaveeffects onexercise tolerancewhichcouldadversely affectadherenceto the practiceof thesephysical activities. The objective of this study was to evaluate the tolerance of the exertion in hypertensive during the use of, hydrochlorothiazide or enalapril associated to hydrochlorothiazide, comparing the results to a one group of normotensives patients. There were 59 adults of both gender, included in the study, 22 normotensive (C=22) and 37 hypertensive. The hypertensive ones were treated with enalapril (E=11), hydrochlorothiazide (H=11), hydrochlorothiazide/enalapril (H/E=15). The tolerance of the exertion was estimated by the consumption of VO2max, MET and lactate, ergometric test were made using Bruce protocol. At the same time the levels of blood pressure and heart rate were measured. CBC, total cholesterol, HDL, LDL, triglycerides, Na+, K+, Ca++, Mg++ , urea, creatinine, uric acid, TSH and fasting glucose, were also tested. The patients treated with enalapril, hydrochlorothiazide and an association of these two drugs showed that the maximum consumption of oxygen and metabolic equivalent were statistically alike. High values of lactate were found just at the initial stage of the test on the hydrochlorothiazide group compared to the normotensives one. The potassium of the hydrochlorothiazide group was lower compared to the ones patients in usingenalapril and the normotensives. The diastolic blood pressure of both fasting and exertion was significantly higher in the enalapril group than in the normotensive group. The other variables did not present statistical differences. The patients, whom were taking enalapril, hydrochlorothiazide and hydrochlorothiazide/enalapril showed tolerance to exercise as well as the normotensive. The best control of systolic blood pressure and diastolic blood pressure occurred in the hydrochlorothiazide group.