Kraft Kenneth A, Arena Ross, Arrowood James A, Fei Ding-Yu
Department of Radiology, Virginia Commonwealth University, Richmond, VA 23298-0072, USA.
Am Heart J. 2007 Nov;154(5):976-82. doi: 10.1016/j.ahj.2007.06.027.
It is unknown whether increased physical fitness reduces aortic stiffness in hypertensive individuals. The purpose of this cross-sectional study was to examine, in a cohort of community-dwelling subjects with no history of cardiac events, differences in the impact of aerobic capacity on aortic stiffness between normotensive and hypertensive subjects.
The study sample included 275 subjects representing a large age range (21-85 years). Of these, 61 subjects (hypertensive cohort) were either hypertensive at enrollment or were taking antihypertensive medication. The remaining 214 subjects (normotensive cohort) had no history of hypertension. The study protocol included maximal cardiopulmonary exercise testing (determination of maximal oxygen consumption, or VO2max) and measurement of aortic wave velocity (AWV) using a novel magnetic resonance-based method.
Overall, the hypertensive cohort exhibited significantly elevated AWV in comparison to a subset of normotensives matched for age, sex, and aerobic fitness. Each cohort was then subdivided according to the percentage of predicted VO2max achieved (< 100% = "unfit," > or = 100% = "fit"). Differences between subgroups were assessed by unpaired t test. In the normotensive cohort, AWV was significantly lower in the fit versus the unfit subgroup. However, in the hypertensive cohort, AWV was not significantly different between fit and unfit subgroups nor between treated and untreated subgroups.
Unlike the situation in healthy normotensive subjects, higher peak aerobic capacity is not associated with lower aortic stiffness in hypertensive individuals.
目前尚不清楚身体素质的提高是否能降低高血压患者的主动脉僵硬度。这项横断面研究的目的是在一组无心脏事件病史的社区居住受试者中,检验正常血压和高血压受试者之间有氧能力对主动脉僵硬度影响的差异。
研究样本包括275名年龄范围较大(21 - 85岁)的受试者。其中,61名受试者(高血压队列)在入组时患有高血压或正在服用抗高血压药物。其余214名受试者(正常血压队列)无高血压病史。研究方案包括最大心肺运动测试(测定最大耗氧量,即VO2max)以及使用一种基于磁共振的新方法测量主动脉波速(AWV)。
总体而言,与年龄、性别和有氧适能相匹配的一部分正常血压受试者相比,高血压队列的AWV显著升高。然后根据达到的预测VO2max百分比(<100% =“不适能”,>或 = 100% =“适能”)对每个队列进行细分。亚组之间的差异通过非配对t检验进行评估。在正常血压队列中,适能亚组的AWV显著低于不适能亚组。然而,在高血压队列中,适能与不适能亚组之间以及治疗与未治疗亚组之间的AWV没有显著差异。
与健康的正常血压受试者不同,高血压患者中较高的峰值有氧能力与较低的主动脉僵硬度无关。