Ehsani A A
Cardiovascular Division, Washington University School of Medicine, 4566 Scott Avenue, St. Louis, MO 63110, USA.
Am J Geriatr Cardiol. 2001 Sep-Oct;10(5):253-9, 273. doi: 10.1111/j.1076-7460.2001.00800.x.
A progressive increase in arterial stiffness with aging contributes to systolic hypertension that results in left ventricular hypertrophy and concentric remodeling in the elderly. Lowering of blood pressure in older adults reduces cardiovascular risks. Endurance exercise training can lower blood pressure in older adults with mild (grade I) hypertension. However, the blood pressure-lowering effect of exercise training, compared with antihypertensive medications, is generally modest for both systolic and diastolic blood pressure. Exercise training alone is likely to be ineffective in lowering blood pressure sufficiently in older adults with moderate to severe (grade II and higher) hypertension. However, exercise and weight loss may potentiate the effects of antihypertensive medications in these subjects. Low-intensity endurance exercise training appears to be most effective in reducing blood pressure in older hypertensive adults. Metabolic adaptations to exercise training can significantly reduce other risk factors for coronary artery disease and atherosclerosis, in addition to reducing blood pressure. Endurance exercise training improves exercise capacity and quality of life, and can induce a modest but significant regression of left ventricular hypertrophy and remodeling in older adults with hypertension.
随着年龄增长，动脉僵硬度逐渐增加，这会导致收缩期高血压，进而引起老年人左心室肥厚和向心性重塑。降低老年人的血压可降低心血管风险。耐力运动训练可降低轻度（I级）高血压老年人的血压。然而，与抗高血压药物相比，运动训练对收缩压和舒张压的降压效果通常较为有限。对于中度至重度（II级及以上）高血压的老年人，仅靠运动训练可能无法充分有效地降低血压。不过，运动和体重减轻可能会增强这些患者抗高血压药物的疗效。低强度耐力运动训练似乎对降低老年高血压患者的血压最为有效。除了降低血压外，运动训练引起的代谢适应还可显著降低冠状动脉疾病和动脉粥样硬化的其他危险因素。耐力运动训练可提高运动能力和生活质量，并能使老年高血压患者的左心室肥厚和重塑出现适度但显著的逆转。
