Physical training effects on large artery hemodynamics and exercise capacity in elderly patients with arterial hypertension

Aim. To assess the effects of a complex treatment programme including the "free load choice" cycling training (FLC-CT) on exercise capacity and large artery hemodynamics in elderly in-patients with arterial hypertension (AH). Material and methods. The study included 81 patients with Stage II (39,5%) or Stage III (60,5%) AH (mean age 75,6 +/- 0,7 years). In total, 50 patients received pharmacotherapy plus FLC-CT. After the treatment, exercise capacity, hemodynamics in common carotid artery (CCA), brachial artery (BA), and femoral artery (FA) (duplex ultrasound), and endothelial function (compression test) were assessed. Results. In elderly All patients, the treatment programme including FLC-CT was more effective than pharmacotherapy in terms of exercise capacity improvement, assessed by veloergometry. An increase in 6-minute walk test distance was observed for the FLC-CT group only. Patients not receiving FLC-CT demonstrated decreased cerebral blood flow in all hemodynamic phases, without an increase in FA blood flow volume. FLC-CT was associated with increased leg blood flow in the rapid phase, without any substantial changes in cerebral blood flow volume. Endothelial reaction in compression test was substantially decreased at baseline and did not change substantially in both treatment groups. Conclusion. Adding FLC-CT to the complex treatment of elderly AH patients improves leg hemodynamics and more effectively increases exercise capacity than pharmaceutical treatment only.