Clinica Medica 4, Department of Clinical and Experimental Medicine, University of Padova, Padua, Italy.
J Hypertens. 2010 Jun;28(6):1186-93.
The objective of this study was to investigate the effect of regular physical activity on the haemodynamic response to public speaking and to evaluate the long-term effect of exercise on development of hypertension.
We assessed 75 sedentary and 44 active participants screened for stage 1 hypertension with consistent activity habits and 63 normotensive individuals as control.
The blood pressure (BP) response to public speaking was assessed with beat-to-beat noninvasive recording. Definition of incident hypertension was based either on clinic or 24-h BP measurement.
The BP response to public speaking was greater in the hypertensive than the normotensive participants (P=0.018/0.009). Among the former, sedentary participants showed increased BP reactivity to the speech test (45.2+/-22.6/22.2+/-11.5mmHg, P<0.01/<0.001 versus controls), whereas physically active participants had a response similar to that of controls (35.4+/-18.5/18.5+/-11.5mmHg, P=not significant). During a median follow-up of 71 months, ambulatory BP did not virtually change in the active participants (-0.9+/-7.8/-0.0+/-4.7mmHg) and increased in their sedentary peers (2.8+/-9.8/3.2+/-7.4mmHg, P=0.08/0.003 versus active). Active participants were less likely to develop incident hypertension than sedentary ones. After controlling for several confounders including baseline heart rate, the hazard ratio was 0.53 [95% confidence interval (CI) 0.31-0.94] for clinic hypertension and 0.60 (95% CI 0.37-0.99) for ambulatory hypertension. Inclusion of BP response to public speaking into the Cox model influenced the strength of the association only marginally [hazard ratio=0.55 (95% CI 0.30-0.97) and hazard ratio=0.59 (95% CI 0.36-0.99), respectively].
Regular physical activity attenuates the BP reaction to psychosocial stressors. However, this mechanism seems to be only partially responsible for the long-term effect of exercise on BP.
本研究旨在探讨规律的身体活动对公开演讲时血液动力学反应的影响，并评估运动对高血压发展的长期影响。
我们评估了 75 名久坐不动的参与者和 44 名有规律活动习惯的活跃参与者，这些参与者筛查出患有 1 期高血压，还有 63 名血压正常的个体作为对照组。
通过无创的实时血压监测评估公开演讲时的血压（BP）反应。高血压的定义是基于诊所或 24 小时血压测量。
与血压正常的参与者相比，高血压参与者的血压对演讲测试的反应更大（45.2+/-22.6/22.2+/-11.5mmHg，P=0.018/0.009）。在前者中，久坐的参与者在演讲测试时的血压反应性增加（45.2+/-22.6/22.2+/-11.5mmHg，P<0.01/<0.001 与对照组相比），而身体活跃的参与者的反应与对照组相似（35.4+/-18.5/18.5+/-11.5mmHg，P=无意义）。在中位数为 71 个月的随访期间，活跃参与者的动态血压几乎没有变化（-0.9+/-7.8/-0.0+/-4.7mmHg），而他们久坐的同伴则增加（2.8+/-9.8/3.2+/-7.4mmHg，P=0.08/0.003 与活跃者相比）。与久坐的参与者相比，活跃的参与者发生高血压的可能性较小。在控制了包括基线心率在内的几个混杂因素后，临床高血压的风险比为 0.53（95%可信区间 0.31-0.94），动态高血压的风险比为 0.60（95%可信区间 0.37-0.99）。将公开演讲时的血压反应纳入 Cox 模型仅略微影响关联的强度[风险比=0.55（95%可信区间 0.30-0.97）和风险比=0.59（95%可信区间 0.36-0.99）]。
规律的身体活动可减轻心理社会应激源对血压的反应。然而，这种机制似乎只是运动对血压的长期影响的部分原因。
