Exercise Performance and Perceived Exertion in Patients With Coronary Insufficiency, Arterial Hypertension and Vasoregulatory Asthenia1

Abstract. A standardized work test has been performed by healthy subjects, patients with coronary heart disease, patients with arterial hypertension, and with the vasoregulatory asthenia syndrome. Heart frequency and rating of perceived exertion according to a rating method were assessed at various work loads. Different measures of physical working capacity were estimated. Patients with vasoregulatory asthenia—and patients with arterial hypertension, although less markedly—rated the exertion to be less in relation to heart frequency than healthy controls, particularly at low rating levels. On the contrary, patients with coronary heart disease rated the exertion to be higher, particularly at high ratings, in relation to heart frequency. In all patient groups studied, there was a smaller mean increase in heart rate in relation to a given increase in rating of exertion, i.e. for a given increase in heart rate there was a greater increase in rating of exertion than in healthy controls. Submaximal measures of physical working capacity were based on heart rate and rating of perceived exertion. The ratio between measurements of physical working capacity based on heart rate and those based on rating of perceived exertion was low in the VA group and high in patients with coronary insufficiency when compared with controls of equal age. Patients with a low “maximal” performance during the test also had a low submaximal physical working capacity estimated from heart frequency as well as from rating of perceived exertion. The difference found between the various patient groups, especially that between patients with coronary heart disease and patients with the vasoregulatory asthenia syndrome is of differential diagnostic value.