University of Connecticut, Storrs, 06269-1110, USA.
Am Heart J. 2010 Sep;160(3):513-20. doi: 10.1016/j.ahj.2010.06.005.
Evidence contends lower levels of physical exertion reduce blood pressure (BP) as effectively as more rigorous levels. We compared the effects of low (40% peak oxygen consumption, Vo(2)peak), moderate (60% Vo(2)peak), and vigorous (100% Vo(2)peak) exercise intensity on the BP response immediately following aerobic exercise. We also examined clinical correlates of the BP response.
Subjects were 45 men (mean +/- SEM, 43.9 +/- 1.4 years) with elevated awake ambulatory BP (ABP, 144.5 +/- 1.5/85.4 +/- 1.2 mm Hg). Men completed four randomly assigned experiments: non-exercise control and three exercise bouts at low, moderate, and vigorous intensity. All experiments began with a baseline period of seated rest. Subjects left the laboratory wearing an ABP monitor.
Systolic ABP increased 2.8 +/- 1.6 mm Hg less after low, 5.4 +/- 1.4 mm Hg less after moderate, and 11.7 +/- 1.5 mm Hg less after vigorous than control over 9 h (P < .001). Diastolic ABP decreased 1.5 +/- 1.2 mm Hg more after low, 2.0 +/- 1.0 mm Hg more after moderate, and 4.9 +/- 1.3 mm Hg more after vigorous versus control over 9 h (P < .010). Baseline correlates of the systolic ABP post-exercise response to vigorous were fasting glucose (r = -0.415), C-reactive protein (r = -0.362), renin (r = -0.348), fasting insulin (r = 0.310), and fasting low density lipoprotein (r = -0.298) (R(2) = 0.400, P = .002). Baseline correlates of the diastolic ABP post-exercise response to vigorous were Vo(2)peak (r = -0.431), fasting low density lipoprotein (r = -0.431), renin (r = -0.411), fibrinogen (r = 0.369), and fasting glucose (r = -0.326) (R(2) = 0.429, P < .001).
The antihypertensive effects of exercise intensity occurred in dose response fashion. Clinicians should weigh the benefits and risks of prescribing vigorous exercise intensity for those with hypertension on an individual basis.
有证据表明,较低水平的体力活动能像更剧烈的水平一样有效地降低血压(BP)。我们比较了低强度(40%最大摄氧量,Vo(2)peak)、中强度(60% Vo(2)peak)和高强度(100% Vo(2)peak)运动强度对有氧运动后即刻血压反应的影响。我们还研究了血压反应的临床相关性。
研究对象为 45 名男性(平均 +/- SEM,43.9 +/- 1.4 岁),其觉醒时的动态血压(ABP,144.5 +/- 1.5/85.4 +/- 1.2mmHg)升高。男性完成了四个随机分配的实验:非运动对照和三个低、中、高强度的运动回合。所有实验均从静坐休息的基线期开始。受试者离开实验室时佩戴 ABP 监测仪。
与对照组相比,低强度、中强度和高强度运动后 9 小时内,收缩压 ABP 分别减少 2.8 +/- 1.6mmHg、5.4 +/- 1.4mmHg 和 11.7 +/- 1.5mmHg(P <.001)。低强度、中强度和高强度运动后,舒张压 ABP 分别增加 1.5 +/- 1.2mmHg、2.0 +/- 1.0mmHg 和 4.9 +/- 1.3mmHg(P <.010)。与剧烈运动后收缩压的运动后反应相关的基线因素包括空腹血糖(r = -0.415)、C 反应蛋白(r = -0.362)、肾素(r = -0.348)、空腹胰岛素(r = 0.310)和空腹低密度脂蛋白(r = -0.298)(R(2) = 0.400,P =.002)。与剧烈运动后舒张压的运动后反应相关的基线因素包括 Vo(2)peak(r = -0.431)、空腹低密度脂蛋白(r = -0.431)、肾素(r = -0.411)、纤维蛋白原(r = 0.369)和空腹血糖(r = -0.326)(R(2) = 0.429,P <.001)。
运动强度的降压作用呈剂量反应关系。对于高血压患者,临床医生应根据个体情况权衡高强度运动的益处和风险。