Heffernan Kevin S, Jae Sae Young, Tomayko Emily, Ishaque Muhammad R, Fernhall Bo, Wilund Kenneth R
The Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
Clin Physiol Funct Imaging. 2009 May;29(3):193-200. doi: 10.1111/j.1475-097X.2009.00856.x. Epub 2009 Feb 19.
Increased carotid intima-media thickness (IMT) with aging is a significant predictor of mortality. Older endurance trained (ET) individuals have lower carotid artery stiffness but similar carotid IMT when compared to sedentary (SED) age-matched peers. The purpose of this study was to examine the contribution of arterial wave reflections to carotid hemodynamics and IMT in older ET and SED with pre-hypertension. Subjects consisted of endurance-trained master athletes and age-matched sedentary controls (mean age 67 years). Carotid artery Beta-stiffness index and IMT was assessed with ultrasonography. Carotid pressure and augmented pressure from wave reflections (obtained from pulse contour analysis) was measured with applanation tonometry. Carotid systolic blood pressure (SBP) and IMT were not different between groups (P>0.05). Carotid stiffness was significantly lower in ET versus SED (7.3 +/- 0.8 versus 9.9 +/- 0.6, P<0.05). Augmented pressure was significantly greater in ET versus SED (17.7 +/- 1.6 versus 13.3 +/- 1.5 mmHg, P<0.05). When adjusting for differences in resting heart rate, there were no group differences in augmented pressure. In conclusion, older ET persons with pre-hypertension have reduced carotid artery stiffness, but similar carotid SBP and carotid IMT when compared to SED. The lack of change in carotid SBP and IMT in older ET may be related to the inability of chronic exercise training to reduce bradycardia-related augmented pressure from wave reflections with aging.
随着年龄增长，颈动脉内膜中层厚度（IMT）增加是死亡率的重要预测指标。与年龄匹配的久坐不动（SED）同龄人相比，耐力训练（ET）的老年人颈动脉僵硬度较低，但颈动脉IMT相似。本研究的目的是探讨动脉波反射对高血压前期老年ET和SED人群颈动脉血流动力学及IMT的影响。研究对象包括耐力训练的老年运动员和年龄匹配的久坐不动对照组（平均年龄67岁）。采用超声检查评估颈动脉β僵硬度指数和IMT。用压平式眼压计测量颈动脉压力和波反射产生的增压（通过脉搏轮廓分析获得）。两组间颈动脉收缩压（SBP）和IMT无差异（P>0.05）。ET组的颈动脉僵硬度显著低于SED组（7.3±0.8对9.9±0.6，P<0.05）。ET组的增压显著高于SED组（17.7±1.6对13.3±1.5 mmHg，P<0.05）。在调整静息心率差异后，两组间增压无差异。总之，高血压前期的老年ET人群与SED人群相比，颈动脉僵硬度降低，但颈动脉SBP和颈动脉IMT相似。老年ET人群颈动脉SBP和IMT无变化，可能与长期运动训练无法随着年龄增长降低与心动过缓相关的波反射增压有关。
