Einstein (São Paulo) (Mar 2009)
Analysis of systemic blood pressure in response to the progressive exercise test of upper and lower limbs in patients with chronic obstructive pulmonary disease
Abstract
Objective: To evaluate the behavior of systemic blood pressure in patients with chronic obstructive pulmonary disease undergoing incremental test of upper and lower limbs. Methods: This is an exploratory, descriptive and prospective study conducted with a sample of 38 patients with chronic obstructive pulmonary disease from the outpatient clinic of Centro de Reabilitação Pulmonar ‘Lar Escola São Francisco’ at Escola Paulista de Medicina of Universidade Federal de São Paulo, where in two visits and after a random assignment, a group of patients underwent an evaluation and progressive effort test. The results were collected and compiled in spreadsheets, and subsequently submitted to statistical analysis. Rresults: It was evaluated 38 patients with chronic obstructive pulmonary disease classified as severe or very severe according to the Global Obstructive Lung Disease (GOLD) classification, after presenting FEV1 ≤ 50% of the predicted value after the use of bronchodilators. Systolic blood pressure measurements immediately after the tests showed higher values for this variable in the group that underwent tests for lower limbs (192.0 ± 27.82 mmHg) when compared to the group for upper limbs (166.09 ± 22.56 mmHg), p = 0.0032. The same finding was seen for diastolic blood pressure and the group of lower limbs presented a mean pressure of 107.33 ± 14.37 mmHg, while in the group of upper limbs the mean pressure was 89.35 ± 12.64 mmHg (p = 0.0003). The variations in blood pressure during the upper limb exercises were analyzed, showing a mean of 36 ± 19.7 mmHg for systolic blood pressure and 7.7 ± 10.8 mmHg for diastolic blood pressure. The group undergoing lower limb exercises presen ted a mean of 62 ± 20.9 mmHg and 24.7 ± 11.3 mmHg for systolic and diastolic blood pressures, respectively. The difference between values was statistically significant (p = 0.0016 and p = 0.0006). Cconclusions: Patients with severe and very severe chronic obstructive pulmonary disease underwent progressive exercise test of upper and lower limbs and presented higher blood pressures, both systolic and diastolic, higher values of cardiac work (measured by heart rate and double product) during the lower limb tests for the same VO2 values, when compared to the peak upper limb tests.
