Seals D R, Reiling M J
Department of Exercise and Sport Sciences, University of Arizona, Tucson.
Hypertension. 1991 Nov;18(5):583-92. doi: 10.1161/01.hyp.18.5.583.
The experimental goals were to determine if regular low-intensity aerobic exercise reduces 24-hour arterial blood pressure in middle-aged and older (aged 50 years or older) humans with mild diastolic (90-105 mm Hg) essential hypertension and, if so, whether this is accurately reflected by changes in casual recordings made at rest. Fourteen subjects walked 3-4 days/wk for 6 months, with 10 exercising an additional 6 months; 12 other subjects served as nonexercising controls. In the exercising subjects, maximal oxygen consumption increased 7-14% (p less than 0.05) with little or no change in body weight or fat. Conventional casual readings of systolic, mean, and diastolic arterial pressure at rest were lower (5-10 mm Hg, p less than 0.05) in all body positions after 6 months of exercise and changed little thereafter. Casual recordings made during additional circulatory measurements showed 6-month decreases of only half this magnitude and were specific to a particular blood pressure phase and body position; however, all changes were significant after 12 months of exercise. The reductions in arterial pressure at rest were associated with decreases in heart rate (p less than 0.05) and cardiac output (p less than 0.05). Ambulatory-determined 24-hour arterial pressure was unchanged after 6 months of exercise, but mean levels were slightly lower (4 mm Hg, p less than 0.05) after 12 months due to reductions in daytime (7 mm Hg, p less than 0.05) and nighttime (4 mm Hg, NS) systolic pressure; diastolic pressure was unchanged throughout the year of training. In the controls, conventionally recorded casual blood pressure levels were lower after 6 months (p less than 0.05), but no other changes were observed in any other variable over the 12 months of study. We conclude 1) regular low-intensity aerobic exercise at best produces only small reductions in 24-hour levels of arterial pressure in middle-aged and older humans with mild (diastolic) essential hypertension and 2) training-associated changes in casually determined blood pressure at rest are dependent on the measurement conditions and, most importantly, do not necessarily reflect the magnitude or even the direction of changes in arterial pressure throughout an entire day.
实验目的是确定规律的低强度有氧运动是否能降低患有轻度舒张期（90 - 105毫米汞柱）原发性高血压的中老年人（年龄50岁及以上）的24小时动脉血压，如果能降低，那么静息时的随机测量值变化是否能准确反映这一情况。14名受试者每周步行3 - 4天，持续6个月，其中10人再额外锻炼6个月；另外12名受试者作为不锻炼的对照组。在锻炼的受试者中，最大摄氧量增加了7 - 14%（p < 0.05），体重或脂肪几乎没有变化。锻炼6个月后，静息时收缩压、平均动脉压和舒张压的常规随机测量值在所有体位均降低（5 - 10毫米汞柱，p < 0.05），此后变化不大。在额外的循环测量期间进行的随机记录显示，6个月时的降低幅度仅为上述幅度的一半，且特定于某个血压阶段和体位；然而，锻炼12个月后所有变化均有统计学意义。静息时动脉压的降低与心率降低（p < 0.05）和心输出量降低（p < 0.05）相关。锻炼6个月后，动态测定的24小时动脉血压无变化，但锻炼12个月后平均水平略有降低（4毫米汞柱，p < 0.05），这是由于白天（7毫米汞柱，p < 0.05）和夜间（4毫米汞柱，无统计学意义）收缩压降低；舒张压在全年训练中无变化。在对照组中，常规记录的随机血压水平在6个月后降低（p < 0.05），但在12个月的研究期间，未观察到其他变量有任何其他变化。我们得出结论：1）规律的低强度有氧运动充其量只能使患有轻度（舒张期）原发性高血压的中老年人的24小时动脉压水平有小幅降低；2）训练相关的静息时随机测定血压的变化取决于测量条件，最重要的是，不一定反映一整天内动脉压变化的幅度甚至方向。
