Clinical and mathematical prediction of the physiotherapy results in adolescents with primary hypertension training on a stationary bike

Abstract

Background. The aim of the research is to clarify the indications for physical rehabilitation of adolescents with primary hypertension based on the individual clinical and mathematical prediction of long-term treatment outcomes. Materials and methods. There were observed 82 adolescents, 44 boys and 38 girls, aged 17.10 ± 0.05 years with a newly diagnosed primary hypertension. Physical rehabilitation for 7 months in the form of exercises on a statio­nary bike was prescribed to 44 patients who formed the main group. The rest of 38 adolescents who did not complete the stationary bike course and adhered to the recommendations for a healthy lifestyle formed the control group. Results. According to the ROC analysis, predictors of an adverse outcome of an attempt at physical rehabilitation were as follows: the ave­rage systolic blood pressure above 130 mm Hg at the start of a program, pulse rate variability index pNN50 of more than 16.6 % and body mass index above 25 kg/m2. Also, for the development of stable hypertension and an increase in the left ventricular posterior wall thickness in diastole above 8.0 mm, the average heart rate at night more than 68 bpm accor­ding to the Holter monitoring and the daily pulse pressure for 24-h monitoring more than 57 mm Hg were unfavorable. Conclusions. Аdolescents with primary hypertension should train at stationary bike in conditions of waiting for an effect of treatment. If an unfavorable course of the disease is predicted, physical rehabilitation must be combined with drug treatment.