Higashi Y, Sasaki S, Kurisu S, Yoshimizu A, Sasaki N, Matsuura H, Kajiyama G, Oshima T
First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
Circulation. 1999 Sep 14;100(11):1194-202. doi: 10.1161/01.cir.100.11.1194.
Several nonpharmacological interventions, including exercise, are recommended in primary prevention of hypertension and other cardiovascular diseases in which the pathogenetic role of endothelial dysfunction has been suggested. We studied the effects of long-term aerobic exercise on endothelial function in patients with essential hypertension.
The forearm blood flow was measured by strain-gauge plethysmography. The responses of forearm vasculature to acetylcholine were smaller in the hypertensive patients than in the normotensive subjects. There was no significant difference in forearm vascular responses to isosorbide dinitrate in the normotensive and hypertensive subjects. We evaluated the effects of physical exercise for 12 weeks on forearm hemodynamics in untreated patients with mild essential hypertension who were divided randomly into an exercise group (n=10) and a control group (n=7). After 12 weeks, the forearm blood flow response to acetylcholine increased significantly, from 25.8+/-9.8 to 32.3+/-11.2 mL. min(-1). 100 mL tissue(-1) (P<0.05), in the exercise group but not in the control group. The increase in the forearm blood flow after isosorbide dinitrate was similar before and after 12 weeks of follow-up in both groups. The infusion of N(G)-monomethyl-L-arginine abolished the exercise-induced enhancement of forearm vasorelaxation evoked by acetylcholine in the exercising group. In normotensive subjects also, long-term aerobic exercise augmented acetylcholine-stimulated nitric oxide release.
These findings suggest that long-term physical exercise improves endothelium-dependent vasorelaxation through an increase in the release of nitric oxide in normotensive as well as hypertensive subjects.
包括运动在内的几种非药物干预措施被推荐用于高血压及其他心血管疾病的一级预防，其中内皮功能障碍的致病作用已被提及。我们研究了长期有氧运动对原发性高血压患者内皮功能的影响。
采用应变片体积描记法测量前臂血流量。高血压患者前臂血管对乙酰胆碱的反应比血压正常者小。血压正常者和高血压患者前臂血管对硝酸异山梨酯的反应无显著差异。我们评估了12周体育锻炼对未经治疗的轻度原发性高血压患者前臂血流动力学的影响，这些患者被随机分为运动组（n = 10）和对照组（n = 7）。12周后，运动组前臂对乙酰胆碱的血流反应显著增加，从25.8±9.8增至32.3±11.2 mL·min⁻¹·100 mL组织⁻¹（P<0.05），而对照组未增加。两组在随访12周前后，硝酸异山梨酯后前臂血流量的增加相似。在运动组中，输注N(G)-单甲基-L-精氨酸消除了运动诱导的乙酰胆碱引起的前臂血管舒张增强。在血压正常的受试者中，长期有氧运动也增加了乙酰胆碱刺激的一氧化氮释放。
这些发现表明，长期体育锻炼通过增加血压正常者和高血压患者一氧化氮的释放来改善内皮依赖性血管舒张。
