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This is a report about the therapeutic behavior of blood pressure and heart rate in patients suffering from hypertension. Forty male patients with hypertension (age: 30-53 years) were treated either with running or swimming therapy according to the stamina principle or with nifedipine therapy (40-60 mg/d). Both groups were randomized. Peripheric hemodynamics were investigated by means of the Xenon-133-muscle-clearance (M. tibialis anterior). The values of interest were half-value time (T1/2) and the mean functional vessel diameter. Additionally total peripheric vascular resistance (TPR) and radiocardiographic cardiac output (CO) were measured. Significant decrease of systolic and diastolic blood pressure values at rest were obtained with the therapeutic regimens. CO increased and the TPR decreased. The decrease of blood pressure during physical therapy and with nifedipine therapy also is due to the enhanced microcirculation. Half-value time of muscle clearance (T1/2) and the mean functional vascular diameter were increased significantly.

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The authors report about a long-term study (three months) on blood pressure and heart rate at rest and during exercise (50 W) in hypertensive patients (WHO stadium I and I, n = 24) running twice a week. The control group were 15 healthy people who were running as well. In addition, the peripheral microcirculation (musculus tibialis anterior) was recorded by the Xenon-133 muscle clearance method and the cardiac output by means of radiocardiography (Indium 113m) as parameter of central hemodynamics. A positive influence of running on hypertension and hemodynamics, resulting in a significant decrease of systolic and diastolic blood pressure and a significant improvement of the peripheral microcirculation was registered. The measured values of blood pressure, heart rate and cardiac output show that there was no cardial risk caused by running at a velocity of 2 to 2.5 m/s.

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Effective treatment of hypertension includes decrease of blood pressure at rest, dynamic and isometric exercise. Therefore, we investigated the hemodynamic changes by radiocardiography (central hemodynamic) and Xenon-133-muscle clearance (peripheral hemodynamic) before and after a sauna treatment during a period of 3 months. 46 hypertensive men (WHO I-II, aged 41 +/- 11 years) participated in the study. Systolic and diastolic blood pressure at rest and during dynamic exercise were decreased significantly (p < or = 0.01) by sauna therapy. Change of blood pressure at isometric exercise was not significant (from 157.5 +/- 16.5 mmHg to 155.0 +/- 15.4 mmHg). The changes of cardiac output and total peripheral resistance were also not significant. Half-time of muscle clearance decreased significantly (from 4.4 +/- 1.9 min to 3.2 +/- 1.2 min, p < or = 0.01) and functional cross-section A increased significantly (from 3.8 +/- 0.9 mm2.c to 4.4 +/- 0.9 mm2.c, p < or = 0.01) after the sauna therapy at dynamic exercise, but not at isometric exercise. These results show the changes between isometric and dynamic exercise, which can only be explained well by a study of peripheral hemodynamic. Contrary to dynamic exercise, sauna therapy did not significantly decrease blood pressure at isometric exercise.

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The authors report on the influence of a single sauna-stay of patients following heart transplantation (HTX) during the rehabilitation phase III. Investigations of blood pressure, heart rate, changer in hemodynamics in the small and large vessels in 8 male patients following HTX (medium age: 42 years) showed that sauna-hyperthermia is well tolerated. We watched significant decreases of blood pressure (systolic and diastolic values), an improvement of the microcirculation in the small vessels, an increase of the left ventricular ejection fraction (LVEF) and a decrease of the total peripheric vascular resistance (TPVR). Possibilities and limitations of sauna-therapy for the therapy of risk factors following HTX especially under immunosuppression are discussed. First results are demonstrated.

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This is a report on the application and importance of nuclear-medical procedures in physical therapy and rehabilitation. In particular, attention is focused on the parameters of peripheric haemodynamics (T1/2 and -A) and of the left ventricular ejection fraction. The authors aim at demonstrating their own results gained during the last 10 years in different groups of patients suffering from cardiovascular diseases at rest and under load. The results are critically estimated, including the relevant literature, and conclusions are drawn for clinical practice.

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It is reported about the influence of the sauna therapy on blood pressure, heart frequency, peripheric hemodynamics (Xenon-133-muscle-clearance) and the reaction of the cardiac output or left ventricular ejection fraction with hypertonia patients, patients with coronary heart disease (CHD) and hypertension and after aneurysm resection after heart infarction. It was shown that sauna therapy has a positive effect on hypertonic regulations troubles. One of the reasons of lowering blood pressure is the significant improvement of the peripheral hemodynamics. Sauna therapy does not result in any improvement of the left ventricles pumping function after operation. All described groups of patients showed a good tolerance and compliance with sauna therapy.

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The authors report on the influence of autogenous training on blood pressure at rest and under stress conditions in patients with coronary heart disease following coronary bypass operation. We investigated the influence of autogenous training on the microcirculation and the left ventricular ejection fraction (LVEF) as well. The results showed a significant decrease in blood pressure at rest and also an increase of muscle circulation F and of LVEF.

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Physical endurance training as practised at spas in the active treatment of hypertension will usually result in an increase in oxygen supply reserves and will also improve haemodynamics, so that it could help in objectively identifying the success of cardiovascular treatment. For this reason we conducted a bicycle ergometer load test in recumbent position in a group of 23 male hypertensives in stages I and II (age between 25 and 58 years) before and after a treatment course at a spa of 4 to 5 weeks' duration. The measurement parameters were ECG, blood pressure, cardiac output and the ventilatory parameters tidal volume, oxygen uptake, respiratory equivalent and respiratory quotient. Significant blood pressure reductions were seen if the load did not exceed 75 watts. The treatment course had a definite influence on cardiac output at rest and under stress. The treatment course achieves reduction and largely also normalisation of the tidal volume which is otherwise higher than in healthy persons. No influence is exercised on the respiratory equivalent. Reduction of the tidal volume and of the oxygen uptake, as well as reduction of the respiratory quotient after the treatment course can be interpreted as an improvement in the economy of the cardiovascular system. The ventilatory parameters are only conditionally suitable for arriving at an objective assessment of the curative effect of the treatment course.

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The authors report about the long-term response (one and three years) of blood pressure and heart frequency under rest and load (50 W) in patients with hypertension, coronary heart disease, essential hypertension and after aortocoronary venous-bypass operation (ACVB) (n = 65) under regular visits (twice a week) to the Finnish sauna. In comparison, 68 hypertensive patients who took a regular kinesiotherapy (running and swimming) were studied. Besides the parameters of heart circulation mentioned above, peripheric microcirculation (M. tibialis anterior) by means of xenon-133 muscle clearance and central hemodynamics by means of LVEF (single probe with In 113) were studied in CHD-patients. Cardiac output at rest and under 50 W load was recorded in hypertensive patients. It was shown that regular balneotherapy had a positive effect on regulation of blood pressure and hemodynamics in patients with hypertension or CHD with hypertension, as had kinesiotherapy in hypertensive patients.

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It is being reported about the influence of a CO2-bathing series with 12 patients after heart-transplantation in connection with a light-motion therapy on blood pressure and haemodynamics. The comparative group was a group of 12 heart-transplantation patients of the same age without cure during the comparative time. It was shown that the balneotherapy after HTPL has positive effect on the development of the systolic blood pressure under rest and exercise. The peripheric microcirculation (musculus tibialis anterior) improved significantly. The left ventricular ejections fraction (LVEF) kept without change. Generally, the balneotherapy is well tolerated by heart-transplantation patients. There is no danger of a cardiac overcharge of the left ventricle.

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Report on mild and single whole body-irradiations with near infrared (IRA). The central body temperature went up to 38.5 degrees C in 9 healthy subjects and 9 patients known as having essential arterial hypertension of the stages I or II. In case of hypertensive patients a single exposure decreased significantly both arterial and venous blood pressure as well as the resulting mean arterial blood pressure. This beneficial effect lasted for at least 24 hours. Besides that, improvement of peripheral hemodynamics and plasma viscosity also was proven. Obviously, improved peripheral hemodynamics is linked to that blood pressure lowering effect which happens due to dilatation of peripheral blood vessels.

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Hyperthermia therapy in hypertensive patients is been discussed as an effective treatment. The aim of this study was to control the behaviour of circulation in conditions of hyperthermia. A group of 6 males, 32-53 years old, suffering from essential hypertension stage I-II underwent a single whole body-irradiation with near infrared (IRA), lasting over one hour. The body temperature rises up to maximal 38.5 degrees C. Before, during and after treatment the blood pressure (BP), the heart rate (HR), the stroke volume (SV), the cardiac output (CO) and the ejection fraction - measured by radionuclide ventriculography - where estimated and the peripheral arterial mean pressure (Pm), the ejection resistance (AW) and the Total peripheral resistance (TpW) were calculated. During irradiations there was a significant decrease of BP, AW and TpW. HR, SV, CO and EF increased significantly. Due to IRA irradiations there was a change in microcirculation with the consequence of lowering the blood pressure. The concomitant stimulation of the heart was well compensated as shown by CO, SV and EF.

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This review focuses on the following aspects of nonpharmacological management concerning elevation of blood pressure: historical development, highlights and theses, possibilities of intervention, as well as favorable observations, advantages (in early diagnosis), disadvantages, fields of application, and integration of this form of treatment into a comprehensive strategy of hypertension control at a population level. A selection of detailed results is elaborated including: possible failure in primary classification of elevated blood pressure and its consequences, the reducibility of the hypertension problem if nonpharmacological measures are generally used, risk factor prevalences in medical and non-medical university cadres, blood pressure reduction in a spa, and hemodynamic changes induced by nonpharmacological or combined antihypertensive treatment simultaneously with drugs. Finally, reference is made to international results, as well as to the importance of the relation between diagnosing and treating blood pressure elevation concomitantly with a simultaneous management of other main risk factors that must be influenced in order to reduce the cardiac risk in hypertensives.

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A ambulatory physical therapeutic rehabilitation by means of interval-run-gymnastic-therapy was examined by a prospective study of 43 patients with peripheral arterial disease of the legs and was estimated as practicable. Improvements of walk distance, lengthenings of the pain times in the standardized move up and down-test, decreases of the blood-pressure gradients by ultrasonic Doppler measurements, shortenings of the half-life periods of xenon-clearance, improvements of the metabolism of lactate, improvements of the parameter of metabolism of lipids and uric acid were proved. Successes of therapy were not proved by oscillography and venous occlusion plethysmography. The expense was registered by the loss of working time and discussed.

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Rehabilitation results are reported concerning the behavior of blood pressure and heart rate, peripheral and central hemodynamics, after resting and during exercise and physical conditioning by running as training and sauna, respectively, in hypertensive patients with IHD after aortocoronary venous bypass (ACVB) surgery. Bicycle ergometric examinations an xenon wash-out (for the determination of the mean functional vessel cross section A) were performed in 43 male untrained patients before and after physical therapy. The left ventricular ejection fraction (EF) at rest was also determined in these patients. Significant increases in the ejection fraction at rest (on average by 7-8%) could be demonstrated in both therapy groups. The group average value for peripheral microcirculation improved only in the sauna group. Blood pressure after resting and on exercise was not influenced. Results are discussed on the basis of the literature and practical conclusions drawn.

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Searching for a possibility of an effective therapy of disturbances of peripheral arterial blood supply (stage I and II), the authors examined a medicamentously untreated group of patients as well as a comparable group of patients which was pretreated with propranolol. The two groups of patients performed twice a week an interval run exercise. Under the three-month training therapy in the two groups significant systolic and diastolic blood pressure reductions as well as statistically ascertained shortenings of the xenon-133-half-value time under working conditions and enlargements of the average functional vascular cross section A appeared. The distance of the intermittent claudication and the standardized moving up and down test prolonged. An influence on the microcirculation caused by propranolol could not be proved. The results are discussed on the basis of literature.

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On the basis of two groups with hypertension (stage I and II) pre-treated with propranolol the authors report on possibilities of the assessment of therapeutic effects in physical therapy series. The systolic and diastolic behaviour of blood pressure at rest and under load as well as the peripheral blood supply before and after the therapeutic effect of sauna bath and running series lasting several weeks were investigated according to the principle of staying power. The xenon-133 muscle clearance served as method for the recognition of the peripheral microcirculation. In the series of sauna bath hyperthermia as well as in the running treatment significant reductions of blood pressure at rest and statistically provable improvements of the peripheral haemodynamics were the result. In higher degrees of load the hypertensive position of regulation is not influenced by the therapeutic method described.

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The authors report results of a three-month-interval running exercise under continuous vasodilatory therapy (Radecol and Jupal) in cases of peripheral arterial blood disturbances (stage I and II). Apart from control examination with the whipping test, the ultra-sound-Doppler method, phlebemphraxis-plethysmography, the paper reports above all the effects of interval running on the peripheral microcirculation of the working muscles which were determined by means of Xenon-133-clearance-half-life. Independent of the type of drug therapy used, significant (1 per cent) improvements of peripheral haemodynamics were found regarding the therapeutic regime presented.

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