Vriz O, Mos L, Frigo G, Sanigi C, Zanata G, Pegoraro F, Palatini P
Division of Cardiology, Ospedale di San Daniele del Friuli, Udine, Italy.
J Sports Med Phys Fitness. 2002 Mar;42(1):83-8.
The aim of the study was to assess the effect of physical activity on 24-hr ambulatory blood pressure (ABPM) and office blood pressure (BP) in 572 male subjects with borderline to mild hypertension from the HARVEST study.
Subjects were 18 to 45 years old with diastolic BP of 90-99 mmHg and/or systolic BP of 140-159 mmHg. They never took any anti-hypertensive therapy. All subjects underwent physical examination, office BP measurement and two 24-hr ambulatory BP monitorings performed three months apart. Subjects were classified as non exercisers, group 1 (n=331), mild exercisers, group 2 (n=192) and heavy exercisers, group 3 (n=49). During the three months of follow-up subjects maintained the same physical activity habits. There was no difference in smoking and alcohol consumption between the 3 groups. As the groups differed significantly in age and body mass index data were adjusted for these confounders.
At baseline office and ambulatory systolic BP were similar in the 3 groups, while diastolic BP was proportional to the level of physical activity although the difference was significant only between the group of non-exercisers and mild exercisers. Heart rate (HR) was always inversely related to the intensity of exercise. After three months follow-up office systolic BP was similar among the three groups and diastolic BP slightly decreased in the exercisers (group 1 vs group 3 p=0.02, group 2 vs group 3 p=0.04). At ABPM the group of heavy exercisers showed a significant decrease in daytime systolic BP (135.4plus minus0.6 vs 134plus minus0.8 vs 132.2plus minus1.6 mmHg; group 1 vs group 3 p<0.05) and the difference between systolic ambulatory BP at the 3rd month and at baseline, showed an additional significant decrease according to exercise intensity (24-hr systolic BP group 1 vs group 3 p=0.001, group 2 vs group 3 p=0.004; daytime systolic BP group 1 vs group 3 p=0.0009, group 2 vs group 3 p=0.004; night-time systolic BP group 1 vs group 3 p=0.02, group 2 vs group 3 p=0.02). No changes in ambulatory diastolic BP were observed.
In conclusion, physical activity has a positive effect in lowering BP attenuating the risk of hypertension in young subjects with borderline hypertension. The anti-hypertensive effect of physical activity persisted after three months and the group of exercisers had an additional reduction in systolic BP detected by ABPM. To obtain accurate information on chronic levels of arterial pressure over time 24-hr ambulatory BP should be preferred to traditional casual readings.
本研究旨在评估体力活动对572名来自HARVEST研究的临界至轻度高血压男性受试者24小时动态血压（ABPM）和诊室血压（BP）的影响。
受试者年龄在18至45岁之间，舒张压为90 - 99 mmHg和/或收缩压为140 - 159 mmHg。他们从未接受过任何抗高血压治疗。所有受试者均接受体格检查、诊室血压测量以及相隔三个月进行的两次24小时动态血压监测。受试者被分为非运动者（第1组，n = 331）、轻度运动者（第2组，n = 192）和重度运动者（第3组，n = 49）。在三个月的随访期间，受试者保持相同的体力活动习惯。三组之间在吸烟和饮酒方面无差异。由于三组在年龄和体重指数上存在显著差异，因此对数据进行了这些混杂因素的校正。
在基线时，三组的诊室和动态收缩压相似，而舒张压与体力活动水平成比例，尽管仅在非运动者组和轻度运动者组之间差异显著。心率（HR）始终与运动强度呈负相关。经过三个月的随访，三组之间的诊室收缩压相似，而运动者组的舒张压略有下降（第1组与第3组p = 0.02，第2组与第3组p = 0.04）。在动态血压监测中，重度运动者组白天收缩压显著下降（135.4±0.6 vs 134±0.8 vs 132.2±1.6 mmHg；第1组与第3组p<0.05），并且第三个月与基线时的动态收缩压差异根据运动强度显示出额外的显著下降（24小时收缩压第1组与第3组p = 0.001，第2组与第3组p = 0.004；白天收缩压第1组与第3组p = 0.0009，第2组与第3组p = 0.004；夜间收缩压第1组与第3组p = 0.02，第2组与第3组p = 0.02）。未观察到动态舒张压的变化。
总之，体力活动对降低血压具有积极作用，可降低临界高血压年轻受试者患高血压的风险。体力活动的抗高血压作用在三个月后持续存在，并且运动者组通过动态血压监测发现收缩压有额外降低。为了获得随时间变化的动脉压慢性水平的准确信息，24小时动态血压应优于传统的偶然测量值。
