Толерантність до фізичного навантаження при артеріальній гіпертензії в дітей шкільного віку залежно від маси тіла

Hypertension and obesity are important problems among adolescents. In clinical practice, these diseases are often combined and worsen the quality of life, so the study on indicators of tolerance to exercise is of great scientific and practical importance. The aim. To determine the state of tolerance to physical activity among school-age children with stable hypertension depending on body weight. Materials and methods. The study involved 95 children aged from 9 to 18 years who were divided into four groups: the first – 18 patients with normal blood pressure and body weight; the second – 39 with stable hypertension and normal body weight; the third – 20 with normal blood pressure and obesity; the fourth – 18 children with stable hypertension and obesity. Exercise tolerance was examined during cycling ergometry according to the PWC 170 protocol; the maximum myocardial oxygen uptake index – VO2peak (the “gold standard” for determining tolerance) was evaluated. Results. According to the study results, among children with a combination of primary hypertension and obesity, the clinical picture of the condition is characterized by significantly more frequent complaints of dizziness, heart pain, headache and loss of consciousness. The total score of complaints was 5.8 ± 1.9 points in the combined pathology of primary hypertension and obesity group, which is significantly higher (P < 0.01) than that among children with primary hypertension or obesity. In primary hypertension and obesity, there is a decrease in VO2peak, which is most pronounced in the combination of these conditions (up to 26.4 ± 6.7 ml/min/kg among boys and up to 22.7 ± 3.6 ml/min/kg among girls) indicating a significant decrease in exercise tolerance. Conclusions. It has been proven that the combined pathology of primary arterial hypertension and obesity among adolescents greatly worsens the clinical condition of children and significantly reduces exercise tolerance more pronounced than in primary arterial hypertension or obesity.