久坐的血压正常绝经后女性急性动态运动的血流动力学后遗症

Hemodynamic after-effects of acute dynamic exercise in sedentary normotensive postmenopausal women.

作者信息

Harvey Paula J, Morris Beverley L, Kubo Toshihiko, Picton Peter E, Su Winnie S, Notarius Catherine F, Floras John S

机构信息

Division of Cardiology, University Health Network, Mount Sinai Hospital, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Hypertens. 2005 Feb;23(2):285-92. doi: 10.1097/00004872-200502000-00010.

Abstract

OBJECTIVES

To determine, in sedentary normotensive postmenopausal women, the after-effects of exercise on systemic and regional hemodynamics, and whether changes in total peripheral conductance after exercise relate to changes in brachial artery flow-mediated vasodilation (FMD).

METHODS

In 13 sedentary postmenopausal women, the blood pressure (BP), cardiac output, total peripheral resistance and total peripheral conductance, calf vascular resistance and FMD were measured during baseline rest, and again commencing 45 min after treadmill exercise. Fourteen premenopausal women completed the identical protocol to obtain reference values for the after-effects of exercise in healthy females.

RESULTS

In postmenopausal women, exercise was followed by falls in systolic BP (P < 0.01) and diastolic BP (P < 0.001). BP did not fall after exercise in premenopausal women. In both groups the cardiac output (P < 0.01) increased and the calf vascular resistance (P < 0.01) and total peripheral resistance (P < 0.05) decreased after exercise, but resistance fell more (P < 0.05) in postmenopausal women. Baseline FMD was greater in premenopausal women (12.1 +/- 1.5 versus 5.3 +/- 1.3%, P < 0.01), and similar before and after exercise, whereas prior exercise nearly doubled the FMD of postmenopausal women (to 9.9 +/- 1.4%, P < 0.01). These increases in FMD correlated with baseline values (r = -0.75, P < 0.01) and with relative changes in total peripheral conductance (r = 0.72, P < 0.02). The latter relationship was absent in premenopausal women (r = -0.29).

CONCLUSIONS

In postmenopausal women, acute dynamic exercise elicits sustained increases in FMD that could facilitate post-exercise hypotension in this population. These observations reinforce the concept of exercise as an important non-pharmacological intervention to modify cardiovascular risk in postmenopausal women.

摘要

目的

在久坐不动的血压正常的绝经后女性中,确定运动对全身和局部血流动力学的后续影响,以及运动后总外周血管传导率的变化是否与肱动脉血流介导的血管舒张(FMD)变化相关。

方法

对13名久坐不动的绝经后女性,在静息基线状态下测量血压(BP)、心输出量、总外周阻力和总外周血管传导率、小腿血管阻力及FMD,在跑步机运动开始45分钟后再次测量。14名绝经前女性完成相同方案以获取健康女性运动后续影响的参考值。

结果

绝经后女性运动后收缩压(P < 0.01)和舒张压(P < 0.001)下降。绝经前女性运动后血压未下降。两组运动后心输出量(P < 0.01)增加,小腿血管阻力(P < 0.01)和总外周阻力(P < 0.05)下降,但绝经后女性阻力下降更明显(P < 0.05)。绝经前女性基线FMD更高(12.1±1.5对5.3±1.3%,P < 0.01),运动前后相似,而运动前绝经后女性的FMD几乎翻倍(至9.9±1.4%,P < 0.01)。这些FMD的增加与基线值相关(r = -0.75,P < 0.01),并与总外周血管传导率的相对变化相关(r = 0.72,P < 0.02)。绝经前女性不存在后一种关系(r = -0.29)。

结论

在绝经后女性中,急性动态运动引起FMD持续增加,这可能有助于该人群运动后低血压。这些观察结果强化了运动作为绝经后女性改善心血管风险的重要非药物干预措施的概念。

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