Features of the cardiovascular system's reactions to stress. Hell hypertensive reaction Hypertensive hell reaction to stress

Determining the type of response of the cardiovascular system to physical activity is based on assessing the direction and severity of changes in basic hemodynamic parameters (heart rate and blood pressure) under the influence of different types of physical activity, as well as the rate of their recovery.
Depending on the direction and severity of changes in heart rate and blood pressure, as well as on the speed of their recovery, five types of response of the cardiovascular system to physical activity are distinguished:

• Normotonic
• Dystonic
• Hypertensive
• With a stepwise increase in maximum blood pressure
• Hypotonic

1. adequate intensity and duration of work performed by increasing heart rate;
2. an adequate increase in pulse pressure (the difference between systolic and diastolic blood pressure) due to an increase in systolic blood pressure and a slight (within 10-35%) decrease in diastolic blood pressure;
3. rapid (i.e., within specified rest intervals) restoration of heart rate and blood pressure to initial values ​​(after 20 squats - 3 minutes, after 15 seconds of running at a maximum pace - 4 minutes, after 3 minutes of running at a pace of 180 steps per minute - 5 min).

Dystonic type reactions, as a rule, occurs after loads aimed at developing endurance, and is characterized by the fact that diastolic blood pressure can be heard down to 0 (the “infinite tone” phenomenon).
When diastolic blood pressure returns to initial values ​​after 1-3 minutes of recovery, this type of reaction is regarded as a variant of the norm; if the “infinite tone phenomenon” persists for a longer time, this is considered an unfavorable sign.

Hypertensive type of reaction characterized by:

1. an increase in heart rate that is inadequate to the load;
2. inadequate load increase in systolic blood pressure to 190-200 mm Hg. (at the same time, diastolic blood pressure also increases slightly);
3. slow recovery of both indicators.

Reaction with a stepwise increase in maximum blood pressure characterized by:

1. a sharp increase in heart rate;
2. an increase in systolic blood pressure that continues during the first 2 to 3 minutes of rest;
3. slow recovery of heart rate and blood pressure.

Hypotonic type reactions characterized by:

1. a sharp, inadequate increase in heart rate;
2. absence of significant changes in blood pressure;
3. slow recovery of heart rate.

The results of the analysis of the dynamics of the type of reaction of the cardiovascular system to an additional control load, which is carried out before and after training (after 10 - 20 minutes), can be used to assessment of immediate tolerance of training sessions.
Any functional test is usually used as this control load (20 squats, 15 s running in place at maximum pace, 1-3 min work on a bicycle ergometer, step test, etc.).
The only requirement isstrict load dosing!!!

In this case, it is customary to distinguish 3 reaction options:

• The first option is characterized by an insignificant difference in the reaction to an additional standard load performed after a sufficiently intense training (class) from the reaction to it before the training. There may be only slight changes in heart rate and blood pressure, as well as in the duration of recovery. Moreover, in some cases the reaction to the load after exercise may be less pronounced, and in others more pronounced, than before exercise. In general, this option shows that the athlete’s functional state does not change significantly after the lesson.
• The second variant of the reaction indicates a deterioration in the functional state, which manifests itself in the fact that after exercise, the shift in heart rate as a reaction to additional load becomes greater, and the rise in blood pressure is smaller than before exercise (the “scissors” phenomenon). The duration of recovery of heart rate and blood pressure usually increases. This may be due to insufficient preparedness of the student or severe fatigue caused by very high intensity and volume of physical activity.
• The third reaction option is characterized by a further deterioration in adaptability to additional load. After an activity aimed at developing endurance, a hypotonic or dystonic reaction appears; after speed-strength exercises, hypertonic, hypotonic and dystonic reactions are possible. Recovery is significantly prolonged. This reaction option indicates a significant deterioration in the functional state of the student. The reason is insufficient preparedness, overwork or excessive workload in class.

There are 5 types of blood pressure response to physical activity:

1. normotonic– systolic blood pressure increases no more than normal (150%) from the initial level; Heart rate increases to 60–80%;

2. hypotonic(asthenic) – systolic blood pressure does not change or decreases; Heart rate increases more than 100% of the original;

3. hypertensive– systolic blood pressure increases by more than 160-180%;

4. dystonic– a sharp decrease in diastal blood pressure to 0 mmHg, the appearance of the “endless tone” phenomenon;

5. stepped– an increase in blood pressure develops over a long period after exercise – 2-3 minutes.

Only type 1 is normal. Hypotonic (2nd) type indicates low physical fitness of the subject. Hypertensive type (3rd) is detected with NCD, the beginning of hypertension. Types 4 and 5 indicate fatigue syndrome.

In addition, there are three type of response to physical activity.

Physiological

- during load: the possibility of increasing the intensity of the load is subjectively felt; Heart rate – within the limits established for a given athlete, free rhythmic breathing.

- good health, a feeling of “muscular joy”; decrease in heart rate to 120 beats/min or less for 3 minutes.

2. "Borderline"

- during load: feeling of extreme load; the appearance of discomfort or pain in the chest; increase in normal breathing rate.

- immediately after exercise (workout): mental depression, after 3 minutes the heart rate is more than 120 beats/min; pain and discomfort even during low-intensity exercise.

Pathological

- during load: loss of coordination, pallor, chest pain, heart rhythm disturbances.

- immediately after exercise (workout): Heart rate within 3 minutes after training exceeds 140 beats/min; chest pain persists; feeling of extreme fatigue, malaise, dizziness.

The dystonic type of reaction, as a rule, occurs after loads aimed at developing endurance, and is characterized by the fact that diastolic blood pressure can be heard to 0 (the “infinite tone” phenomenon).

When diastolic blood pressure returns to initial values ​​in the 1-3 minutes of recovery, this type of reaction is regarded as a variant of the norm; if the “infinite tone phenomenon” persists for a longer time - as an unfavorable sign.
The hypertensive type of reaction is characterized by:
- inadequate increase in heart rate to the load;
- inadequate load increase in systolic blood pressure to 190-200 mm Hg. Art. (at the same time, diastolic pressure also increases slightly);
- slow recovery of both indicators.
The hypertensive type of reaction indicates a violation of regulatory mechanisms, causing a decrease in the efficiency of the functioning of the heart. It is observed in chronic overstrain of the central nervous system (neurocirculatory dystonia of the hypertensive type), chronic overstrain of the cardiovascular system (hypertensive variant), in pre- and hypertensive patients.
A reaction with a stepwise increase in maximum blood pressure is characterized by:
- a sharp increase in heart rate;
- an increase in systolic blood pressure that continues during the first 2-3 minutes of rest;
- slow recovery of heart rate and blood pressure.
This type of reaction is unfavorable. It reflects the inertia of regulatory systems and is recorded, as a rule, after high-speed loads.
The hypotonic type of reaction is characterized by:
- a sharp increase in heart rate inadequate to the load;
- absence of significant changes in blood pressure;
- slow recovery of heart rate.
The hypotonic type of reaction is the most unfavorable.
Flack straining test.
The subject is asked to take a deep breath, followed by imitation of exhalation to maintain a pressure in the manometer of 40 mmHg. Art. While straining “to failure”, the pulse is recorded at intervals of 5. The total time during which the subject is able to complete the test is also recorded.
Evaluation principles:
- excellent response - heart rate increases by 1-2 beats every 5 seconds in relation to the initial data. The duration of straining is 45-55 s. The increase in heart rate compared to the initial data continues for about a minute, then the heart rate stabilizes;
- good reaction - pulse acceleration is 3-4 beats in 5 s;
- satisfactory reaction - pulse acceleration is 5-7 beats in 5 s;
- unsatisfactory reaction - an even higher increase in heart rate. Satisfactory and unsatisfactory reactions to the test indicate changes in the regulation of cardiac activity.
Burger's straining test.
At rest, the subject's blood pressure is measured. Then he is asked to take 10 deep breaths in 20 seconds, at the end of which another blood pressure measurement is taken. After the 10th inhalation, the subject exhales into the mouthpiece, increasing the pressure in the manometer to 40-60 mmHg. Art., and maintains the range of this pressure for 20 s. Blood pressure is measured at the beginning of straining and after it ends. Evaluation principles:
- the normal type of reaction is that the maximum blood pressure remains almost unchanged throughout the entire period of straining;
- second type of reaction: blood pressure increases during straining and returns to the original values ​​20-30 s after its cessation;
- the third type of reaction (negative reaction to the test) is expressed in a significant drop in blood pressure during straining, which indicates a violation of the regulation of vascular tone, which can lead to a short-term loss of consciousness.
The assessment of the electrocardiogram during routine monitoring of athletes (12-16 hours after training or after a day of rest) is carried out primarily from the position of excluding a possible dystrophic variant of chronic physical overstrain of the heart.
T wave changes play a major role in diagnosis; segment changes
ST - auxiliary; changes in the U wave are optional.

BMI = body weight (kg) / height2 (m)

Body mass index (BMI) is used to estimate weight in relation to height and provides a reasonable estimate of total body fat in studies involving specific populations. In addition, BMI correlates with both morbidity and mortality, thus providing a direct indicator of health status and risk of disease.

The method does not provide information about the distribution of fat in different parts of the body, it is difficult to explain to the client and it is difficult to plan for actual weight loss due to changes in BMI. In addition, BMI has been shown to overestimate body fat mass in muscular individuals (eg, many athletes) and underestimate in individuals with loss of muscle mass (eg, older adults).
Excess weight is defined when BMI is 25–29 kg/m2, and obesity is defined when BMI is greater than 30 kg/m2. In people with a BMI greater than 20 kg/m2, mortality for many health conditions increases with increasing body weight.
World Health Organization (WHO), for men and women, recommended BMI, 20 – 25 kg/m2

Vegetative index (Kerdo index)

VI = (1 – ABP/HR) X 100
VI is considered to be one of the simplest indicators of the functional state of the autonomic nervous system, reflecting the ratio of the excitability of its sympathetic and parasympathetic divisions (excitation and inhibition, respectively - SSF). The value of VI in the range from -15 to +15 indicates the balance of sympathetic and parasympathetic influences. A VI value greater than 15 indicates a predominance of the tone of the sympathetic division of the autonomic nervous system and indicates satisfactory adaptation to the workload; a VI value less than minus 15 indicates a predominance of the tone of the parasympathetic division of the autonomic nervous system, which is a sign of the presence of a dynamic mismatch (Rozhentsov, Polevshchikov, 2006; S. – 156).
For a trained person, VI before exercise usually has a minus sign, or ranges from - 15 to + 15.
An excessive increase in VI usually indicates a person’s hypertensive reaction to the load - a discrepancy between the proposed load and the level of training. Such loads should not be frequent even among well-trained athletes.
A decrease in VI also indicates poor exercise tolerance. VI values ​​below – 15 indicate the most unfavorable type of response of the autonomic nervous system to stress – hypotonic.

Blood pressure (BP)

It is measured at rest, so there should be no activity for 15 minutes before its determination. If systolic pressure exceeds 126 mm Hg. Art., and diastolic – 86 mm Hg. Art., measure it again after hyperventilation (five maximum deep and fast inhalations and exhalations). if the pressure remains elevated, check the cuff width and take readings again after 15 minutes. If it continues to be elevated, conduct a more in-depth examination.
Gender differences do not affect blood pressure levels, but after puberty (16–18 years), blood pressure in men is slightly higher than in women. Daily fluctuations in blood pressure are at least 10–20 mmHg. Art. and decrease during night sleep.
Horizontal body position, physical and mental rest are among the factors that reduce blood pressure. Eating, smoking, physical and mental stress leads to increased blood pressure. With heavy physical activity, blood pressure can increase significantly. The ADD reaction is especially important. In trained athletes, intense exercise is accompanied by a decrease in blood pressure.
BP in obese people is higher than in people with normal or low weight (muscle mass). In athletes living in cold climates, blood pressure is 10 mm Hg. Art. higher, in warm weather there is a tendency towards a decrease in blood pressure.
Normally, there is a pressure asymmetry: blood pressure on the right shoulder is slightly higher than on the left. In rare cases, the difference reaches 20 and even 40 mmHg. Art.

Systolic pressure (SBP)

Systolic pressure is considered normal at values ​​from 90 to 120 mmHg.

• A value below 90 is hypotension, most often observed in women due to low absolute muscle and body mass in general, as well as short stature. It may also indicate insufficient nutrition (starvation, unphysiological diet).
• Values ​​from 120 to 130 mm Hg – moderately elevated blood pressure. Moderately elevated blood pressure can be observed at rest in individuals with large heights, body weight and/or muscle mass (especially with a sharp increase in body weight). It may be caused by a person's agitation before exercise, white coat syndrome, or caused by a recent meal.
• 140 and above are a sign of hypertension, but multiple measurements throughout the day are required to confirm the diagnosis. If the diagnosis is confirmed, the doctor is obliged to recommend taking medications that normalize blood pressure.

Diastolic pressure (DBP)

It is considered normal at values ​​from 60 to 80 mm Hg.

• Values ​​from 80 to 90 mm Hg indicate a moderately increased blood pressure.
• Blood pressure of 90 mmHg and above is a sign of hypertension.

It should be noted that the final conclusion is made not based on the best, but on the worst of the indicators. Thus, both 141 over 80 and 130 over 91 indicate hypertension.

Pulse pressure (PP)

Defined as the difference between systolic and diastolic pressure. All other things being equal (same peripheral resistance, blood viscosity, etc.), pulse pressure changes parallel to the value of systolic blood volume (an indirect indicator of myocardial load). Normally it is 40 – 70 mmHg. Art. Pulse pressure may increase as a result of an increase in blood pressure or a decrease in blood pressure

Mean arterial pressure (MAP)

SBP = ADD + 1/3(ADS - ADD)
All changes in mean arterial pressure are determined by changes in cardiac output (MV) or total peripheral resistance (TPR)
SAD = MO x OPS
A normal SBP can be maintained against the background of a decrease in OPS due to a compensatory increase in the MO.

Five types of cardiovascular system (CVS) response to physical activity
(Kukolevsky, 1975; Epifanov. 1990; Makarova, 2002)

1. Normotonic type of CV response on physical activity is characterized by:

• adequate intensity and duration of work performed by increasing heart rate, within 50 - 75% (Epifanov, 1987);
• an adequate increase in pulse blood pressure (the difference between systolic and diastolic blood pressure) due to an increase in systolic blood pressure (no more than 15 - 30% (Epifanov, 1987)) and a small increase (within 10 - 35% (Makarova, 2002), 10 - 25 % (Epifanov, 1987)) by a decrease in diastolic blood pressure, an increase in pulse pressure by no more than 50 - 70% (Epifanov, 1987).
• rapid (i.e., within specified rest intervals) restoration of heart rate and blood pressure to initial values

The normotonic type of reaction is the most favorable and reflects the body’s good adaptability to physical activity.

2. Dystonic type of reaction , as a rule, occurs after loads aimed at developing endurance, and is characterized by the fact that diastolic blood pressure is heard to 0 (the “infinite tone” phenomenon), systolic blood pressure rises to values ​​of 180 – 200 mm Hg. Art. (Karpman, 1980). This type of reaction may occur after repeated exercise after exercise.
When diastolic blood pressure returns to initial values ​​within 1–3 minutes of recovery, this type of reaction is regarded as a variant of the norm; if the “endless tone” phenomenon persists for a longer time, it is considered an unfavorable sign (Karpman, 1980; Makarova, 2002).

3. Hypertensive type of reaction characterized by:

• an increase in heart rate that is inadequate to the load;
• inadequate load increase in systolic blood pressure to 190 – 200 (up to 220) mm Hg. Art. more than 160 - 180% (Epifanov, Apanasenko, 1990) (at the same time, diastolic pressure also increases slightly by more than 10 mm Hg (Epifanov, Apanasenko, 1990) or does not change, which is due to a significant hemodynamic shock during physical activity in some athletes (Karpman, 1980));
• slow recovery of both indicators.

The hypertensive type of reaction indicates a violation of regulatory mechanisms that cause a decrease in the efficiency of the functioning of the heart. It is observed in chronic overstrain of the central nervous system (neurocirculatory dystonia of the hypertensive type), chronic overstrain of the cardiovascular system (hypertensive variant) in pre- and hypertensive patients.

4. Stepwise reaction maximum blood pressure is characterized by:

• a sharp increase in heart rate;
• an increase in systolic blood pressure that continues in the first 2–3 minutes of rest compared to the 1st minute of recovery;

This type of reaction is unfavorable. It reflects the inertia of regulatory systems and is recorded, as a rule, after high-speed loads (Makarova, 2002). Experience indicates that this type of reaction is associated with a deterioration in the functional state of the athlete’s body (Karpman, 1980, p. 113). The time for performing the load (30 s) may be insufficient to train the cardiovascular system, which, according to a number of indicators, lasts 1 – 3 minutes. In some individuals, despite the cessation of the load, the development of circulatory function may continue for some time (Karpman, 1980, ibid.). Thus, this type of reaction is most likely to occur after the first test of 20 squats, which is performed before class.

5. Hypotonic type of reaction characterized by:

• a sharp, inadequate increase in heart rate (up to 170–190 beats/min (Karpman, 1980); more than 100% (Epifanov, Apanasenko, 1990); up to 120–150% (Epifanov, 1987));
• absence of significant changes in blood pressure (systolic pressure slightly or does not increase at all, and sometimes even decreases, pulse pressure decreases (Epifanov, Apanasenko, 1990));
• slow recovery of heart rate and blood pressure.

The hypotonic type of reaction is the most unfavorable. It reflects a disturbance (decrease) in the contractile function of the heart (“hyposystole syndrome” in the clinic) and is observed in the presence of pathological changes in the myocardium (Makarova, 2002). Apparently, the increase in cardiac output is provided mainly by an increase in heart rate, while the increase in systolic volume is small (Karpman, 1980).
Pathological reactions to stress during regular physical training can turn into physiological ones (Epifanov, 1987, p. 50). With unfavorable types of reactions, which most often appear at the beginning of the preparatory period (Karpman, 1980., P. 114), additional (clarifying) pressure measurements are possible, described (Richard D. H. Backus, and David K. Reid 1998., P. 372 ).

Additional Information.

If high-intensity training sessions are planned (especially preparation for competitions), it is necessary that the client undergo a full medical examination (including a dentist).
To check the state of the cardiovascular system, it is necessary to perform an ECG under stress. Possible myocardial pathologies are revealed by an echocardiogram.
Be sure to evaluate your diet (analysis of everything you ate for a week or more) and daily routine - the possibility of organizing adequate recovery.
It is strictly forbidden to prescribe medications to a client (especially hormonal ones) - this is the responsibility of the doctor.

Referring the client for echocardiography and stress ECG to exclude cardiac pathology is recommended under the following circumstances:

• Positive answers to questions about symptoms of cardiovascular diseases
• Slow recovery of pulse and/or respiration during orientation
• High heart rate and blood pressure with light loads
• Unfavorable type of reaction to physical activity
• History of cardiovascular diseases (previous)

Before receiving the test results:

• Pulse when walking is not higher than 60% of the maximum (220 - age). If possible, introduce additional aerobic exercise on days free from strength training, gradually increasing its duration to 40 - 60 minutes.
• The strength part of the lesson is 30-40 minutes, monitor the technique of performing the exercises, use a tempo of 3:0.5:2:0, while controlling your breathing (do not hold your breath). Use alternating exercises for “top” and “bottom”. Don't rush to increase intensity
• Of the available control methods Necessarily use blood pressure measurements before and after training, heart rate before and after (if you have a heart rate monitor, then during training). Observe the speed of breathing recovery, do not start the next approach until it normalizes.

The article was prepared by Sergey Strukov

BMI = body weight (kg) / height2 (m)

Body mass index (BMI) is used to estimate weight in relation to height and provides a reasonable estimate of total body fat in studies involving specific populations. In addition, BMI correlates with both morbidity and mortality, thus providing a direct indicator of health status and risk of disease.

The method does not provide information about the distribution of fat in different parts of the body, it is difficult to explain to the client and it is difficult to plan for actual weight loss due to changes in BMI. In addition, BMI has been shown to overestimate body fat mass in muscular individuals (eg, many athletes) and underestimate in individuals with loss of muscle mass (eg, older adults).
Excess weight is defined when BMI is 25–29 kg/m2, and obesity is defined when BMI is greater than 30 kg/m2. In people with a BMI greater than 20 kg/m2, mortality for many health conditions increases with increasing body weight.
World Health Organization (WHO), for men and women, recommended BMI, 20 – 25 kg/m2

Vegetative index (Kerdo index)

VI = (1 – ABP/HR) X 100
VI is considered to be one of the simplest indicators of the functional state of the autonomic nervous system, reflecting the ratio of the excitability of its sympathetic and parasympathetic divisions (excitation and inhibition, respectively - SSF). The value of VI in the range from -15 to +15 indicates the balance of sympathetic and parasympathetic influences. A VI value greater than 15 indicates a predominance of the tone of the sympathetic division of the autonomic nervous system and indicates satisfactory adaptation to the workload; a VI value less than minus 15 indicates a predominance of the tone of the parasympathetic division of the autonomic nervous system, which is a sign of the presence of a dynamic mismatch (Rozhentsov, Polevshchikov, 2006; S. – 156).
For a trained person, VI before exercise usually has a minus sign, or ranges from - 15 to + 15.
An excessive increase in VI usually indicates a person’s hypertensive reaction to the load - a discrepancy between the proposed load and the level of training. Such loads should not be frequent even among well-trained athletes.
A decrease in VI also indicates poor exercise tolerance. VI values ​​below – 15 indicate the most unfavorable type of response of the autonomic nervous system to stress – hypotonic.

Blood pressure (BP)

It is measured at rest, so there should be no activity for 15 minutes before its determination. If systolic pressure exceeds 126 mm Hg. Art., and diastolic – 86 mm Hg. Art., measure it again after hyperventilation (five maximum deep and fast inhalations and exhalations). if the pressure remains elevated, check the cuff width and take readings again after 15 minutes. If it continues to be elevated, conduct a more in-depth examination.
Gender differences do not affect blood pressure levels, but after puberty (16–18 years), blood pressure in men is slightly higher than in women. Daily fluctuations in blood pressure are at least 10–20 mmHg. Art. and decrease during night sleep.
Horizontal body position, physical and mental rest are among the factors that reduce blood pressure. Eating, smoking, physical and mental stress leads to increased blood pressure. With heavy physical activity, blood pressure can increase significantly. The ADD reaction is especially important. In trained athletes, intense exercise is accompanied by a decrease in blood pressure.
BP in obese people is higher than in people with normal or low weight (muscle mass). In athletes living in cold climates, blood pressure is 10 mm Hg. Art. higher, in warm weather there is a tendency towards a decrease in blood pressure.
Normally, there is a pressure asymmetry: blood pressure on the right shoulder is slightly higher than on the left. In rare cases, the difference reaches 20 and even 40 mmHg. Art.

Systolic pressure (SBP)

Systolic pressure is considered normal at values ​​from 90 to 120 mmHg.

• A value below 90 is hypotension, most often observed in women due to low absolute muscle and body mass in general, as well as short stature. It may also indicate insufficient nutrition (starvation, unphysiological diet).
• Values ​​from 120 to 130 mm Hg – moderately elevated blood pressure. Moderately elevated blood pressure can be observed at rest in individuals with large heights, body weight and/or muscle mass (especially with a sharp increase in body weight). It may be caused by a person's agitation before exercise, white coat syndrome, or caused by a recent meal.
• 140 and above are a sign of hypertension, but multiple measurements throughout the day are required to confirm the diagnosis. If the diagnosis is confirmed, the doctor is obliged to recommend taking medications that normalize blood pressure.

Diastolic pressure (DBP)

It is considered normal at values ​​from 60 to 80 mm Hg.

• Values ​​from 80 to 90 mm Hg indicate a moderately increased blood pressure.
• Blood pressure of 90 mmHg and above is a sign of hypertension.

It should be noted that the final conclusion is made not based on the best, but on the worst of the indicators. Thus, both 141 over 80 and 130 over 91 indicate hypertension.

Pulse pressure (PP)

Defined as the difference between systolic and diastolic pressure. All other things being equal (same peripheral resistance, blood viscosity, etc.), pulse pressure changes parallel to the value of systolic blood volume (an indirect indicator of myocardial load). Normally it is 40 – 70 mmHg. Art. Pulse pressure may increase as a result of an increase in blood pressure or a decrease in blood pressure

Mean arterial pressure (MAP)

SBP = ADD + 1/3(ADS - ADD)
All changes in mean arterial pressure are determined by changes in cardiac output (MV) or total peripheral resistance (TPR)
SAD = MO x OPS
A normal SBP can be maintained against the background of a decrease in OPS due to a compensatory increase in the MO.

Five types of cardiovascular system (CVS) response to physical activity
(Kukolevsky, 1975; Epifanov. 1990; Makarova, 2002)

1. Normotonic type of CV response on physical activity is characterized by:

• adequate intensity and duration of work performed by increasing heart rate, within 50 - 75% (Epifanov, 1987);
• an adequate increase in pulse blood pressure (the difference between systolic and diastolic blood pressure) due to an increase in systolic blood pressure (no more than 15 - 30% (Epifanov, 1987)) and a small increase (within 10 - 35% (Makarova, 2002), 10 - 25 % (Epifanov, 1987)) by a decrease in diastolic blood pressure, an increase in pulse pressure by no more than 50 - 70% (Epifanov, 1987).
• rapid (i.e., within specified rest intervals) restoration of heart rate and blood pressure to initial values

The normotonic type of reaction is the most favorable and reflects the body’s good adaptability to physical activity.

2. Dystonic type of reaction , as a rule, occurs after loads aimed at developing endurance, and is characterized by the fact that diastolic blood pressure is heard to 0 (the “infinite tone” phenomenon), systolic blood pressure rises to values ​​of 180 – 200 mm Hg. Art. (Karpman, 1980). This type of reaction may occur after repeated exercise after exercise.
When diastolic blood pressure returns to initial values ​​within 1–3 minutes of recovery, this type of reaction is regarded as a variant of the norm; if the “endless tone” phenomenon persists for a longer time, it is considered an unfavorable sign (Karpman, 1980; Makarova, 2002).

3. Hypertensive type of reaction characterized by:

• an increase in heart rate that is inadequate to the load;
• inadequate load increase in systolic blood pressure to 190 – 200 (up to 220) mm Hg. Art. more than 160 - 180% (Epifanov, Apanasenko, 1990) (at the same time, diastolic pressure also increases slightly by more than 10 mm Hg (Epifanov, Apanasenko, 1990) or does not change, which is due to a significant hemodynamic shock during physical activity in some athletes (Karpman, 1980));
• slow recovery of both indicators.

The hypertensive type of reaction indicates a violation of regulatory mechanisms that cause a decrease in the efficiency of the functioning of the heart. It is observed in chronic overstrain of the central nervous system (neurocirculatory dystonia of the hypertensive type), chronic overstrain of the cardiovascular system (hypertensive variant) in pre- and hypertensive patients.

4. Stepwise reaction maximum blood pressure is characterized by:

• a sharp increase in heart rate;
• an increase in systolic blood pressure that continues in the first 2–3 minutes of rest compared to the 1st minute of recovery;

This type of reaction is unfavorable. It reflects the inertia of regulatory systems and is recorded, as a rule, after high-speed loads (Makarova, 2002). Experience indicates that this type of reaction is associated with a deterioration in the functional state of the athlete’s body (Karpman, 1980, p. 113). The time for performing the load (30 s) may be insufficient to train the cardiovascular system, which, according to a number of indicators, lasts 1 – 3 minutes. In some individuals, despite the cessation of the load, the development of circulatory function may continue for some time (Karpman, 1980, ibid.). Thus, this type of reaction is most likely to occur after the first test of 20 squats, which is performed before class.

5. Hypotonic type of reaction characterized by:

• a sharp, inadequate increase in heart rate (up to 170–190 beats/min (Karpman, 1980); more than 100% (Epifanov, Apanasenko, 1990); up to 120–150% (Epifanov, 1987));
• absence of significant changes in blood pressure (systolic pressure slightly or does not increase at all, and sometimes even decreases, pulse pressure decreases (Epifanov, Apanasenko, 1990));
• slow recovery of heart rate and blood pressure.

The hypotonic type of reaction is the most unfavorable. It reflects a disturbance (decrease) in the contractile function of the heart (“hyposystole syndrome” in the clinic) and is observed in the presence of pathological changes in the myocardium (Makarova, 2002). Apparently, the increase in cardiac output is provided mainly by an increase in heart rate, while the increase in systolic volume is small (Karpman, 1980).
Pathological reactions to stress during regular physical training can turn into physiological ones (Epifanov, 1987, p. 50). With unfavorable types of reactions, which most often appear at the beginning of the preparatory period (Karpman, 1980., P. 114), additional (clarifying) pressure measurements are possible, described (Richard D. H. Backus, and David K. Reid 1998., P. 372 ).

Additional Information.

If high-intensity training sessions are planned (especially preparation for competitions), it is necessary that the client undergo a full medical examination (including a dentist).
To check the state of the cardiovascular system, it is necessary to perform an ECG under stress. Possible myocardial pathologies are revealed by an echocardiogram.
Be sure to evaluate your diet (analysis of everything you ate for a week or more) and daily routine - the possibility of organizing adequate recovery.
It is strictly forbidden to prescribe medications to a client (especially hormonal ones) - this is the responsibility of the doctor.

Referring the client for echocardiography and stress ECG to exclude cardiac pathology is recommended under the following circumstances:

• Positive answers to questions about symptoms of cardiovascular diseases
• Slow recovery of pulse and/or respiration during orientation
• High heart rate and blood pressure with light loads
• Unfavorable type of reaction to physical activity
• History of cardiovascular diseases (previous)

Before receiving the test results:

• Pulse when walking is not higher than 60% of the maximum (220 - age). If possible, introduce additional aerobic exercise on days free from strength training, gradually increasing its duration to 40 - 60 minutes.
• The strength part of the lesson is 30-40 minutes, monitor the technique of performing the exercises, use a tempo of 3:0.5:2:0, while controlling your breathing (do not hold your breath). Use alternating exercises for “top” and “bottom”. Don't rush to increase intensity
• Of the available control methods Necessarily use blood pressure measurements before and after training, heart rate before and after (if you have a heart rate monitor, then during training). Observe the speed of breathing recovery, do not start the next approach until it normalizes.

The article was prepared by Sergey Strukov