The blood pressure response in children with normal hearts at peak exercise

Kik, J.O. (Jolien) (2015) The blood pressure response in children with normal hearts at peak exercise. thesis, Medicine.

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Abstract

Introduction Exercise tests are very useful in the treatment and follow-up of heart diseases. Problems in the cardiovascular system are the most common congenital abnormalities with an overall 20-year survival rate of 89.5%. A good follow-up during this time is important and exercise test form part of this. Nevertheless, in children a standard for blood pressure response during exercise has not been developed yet. This is an important omission since this response is used to guide therapy in several cardiac conditions. This study aims to make a first step towards such a standard for blood pressure response. Methods The data of 133 children are included ranging in age from four to eighteen. These comprise 68 (51 %) boys and 65 (49 %) girls. All participants underwent a treadmill exercise test according to the Bruce protocol. Before and during the exercise the heart rate and blood pressure were measured. Also, data on the height, weight, age of every participant were collected. To be included participants had to reach peak heart rate, which was defined as achieving 85% of their maximum heart rate (calculated with the formula 210 – 0.65 x the age of the subject (years) and determined after the exercise test). The data have been tested on correlation (R2) and the p – values have been calculated with an one-way ANOVA test. Results Systolic blood pressure appeared to be a suitable parameter to measure blood response during exercise; diastolic blood pressure did not show clear responses. Systolic blood pressure was positively correlated with age at rest and during peak exercise. Age is widely used as a parameter to describe systolic (and diastolic) blood pressure at rest in adults and, to a lesser extent, in children. Systolic blood pressure at peak exercise was positively correlated with biometrical parameters (height, weight, BMI and BSA). Of these BSA (Mosteller) appeared to have the strongest correlation with peak systolic blood pressure in males, females, and males and females combined (R2 = 0.2578, 0.3636, 0.3017 respectively). For the development of a standard for the blood pressure response to exercise in children, age and BSA (Mosteller) appeared the most suitable parameters. Thus, peak systolic blood pressure (mean ± 2sd) has been plotted against age and against BSA (Mosteller) for males, females, and males and females. Conclusion This study showed some promising results on the blood pressure response during exercise. This study indicates that systolic blood pressure versus age and systolic blood pressure versus BSA give good correlations and might be good parameters for future guidelines.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Berger, Prof. Dr. R.M.F. and University Medical Centre Groningen
Supervisor name:	Second supervisor: and Cheung, Prof. Dr. M. and Cardiology Department at the Royal Children’s Hospital and and Murdoch Childrens Research Institute in Melbourne, Australia
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:53
Last Modified:	25 Jun 2020 10:53
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1402

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