Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil.
Maturitas. 2011 Jun;69(2):189-94. doi: 10.1016/j.maturitas.2011.03.017. Epub 2011 Apr 14.
Emerging data reveal that oral estrogen therapy can increase clinic blood pressure (BP) in post-menopausal women; however, it is important to establish its effects on ambulatory BP, which is a better predictor for target-organ damage. Besides estrogen therapy, aerobic training is widely recommended for post-menopausal women, and it can decrease ambulatory BP levels. This study was designed to evaluate the effect of aerobic training and estrogen therapy on the ambulatory BP of post-menopausal women. Forty seven healthy hysterectomized women were randomly divided (in a double-blind manner) into 4 groups: placebo-control (PLA-CO=12), estrogen therapy-control (ET-CO=14), placebo-aerobic training (PLA-AT=12), and estrogen therapy-aerobic training (ET-AT=09). The ET groups received estradiol valerate (1 mg/day) and the AT groups performed cycle ergometer, 3×/week at moderate intensity. Hormonal status (blood analysis), maximal cardiopulmonary exercise test (VO(2) peak) and ambulatory BP (24-h, daytime and nighttime) was evaluated before and 6 months after interventions. A significant increase in VO(2) peak was observed only in women who participated in aerobic training groups (+4.6±1.0 ml kg(-1) min(-1), P=0.00). Follicle-stimulating hormone was a significant decreased in the ET groups (-18.65±5.19 pg/ml, P=0.00), and it was accompanied by an increase in circulating estrogen (56.1±6.6 pg/ml). A significant increase was observed in the ET groups for daytime (P=0.01) and nighttime systolic BP (P=0.01), as well as nighttime diastolic BP (P=0.02). However, daytime diastolic BP was increased only in the ET-CO group (+3.4±1.2 mmHg, P=0.04), and did not change in any other groups. No significant effect was found in ambulatory heart rate. In conclusion, aerobic training abolished the increase of daytime ambulatory BP induced by estrogen therapy in hysterectomized, healthy, normotensive and postmenopausal women.
新数据表明，口服雌激素治疗会使绝经后妇女的诊室血压升高；然而，确定其对动态血压的影响很重要，因为动态血压是预测靶器官损害的更好指标。除了雌激素治疗，有氧运动也被广泛推荐用于绝经后妇女，并且可以降低动态血压水平。本研究旨在评估有氧运动和雌激素治疗对绝经后妇女动态血压的影响。47 名健康的子宫切除术后女性被随机分为 4 组（双盲）：安慰剂对照（PLA-CO=12）、雌激素治疗对照（ET-CO=14）、安慰剂有氧运动（PLA-AT=12）和雌激素治疗有氧运动（ET-AT=09）。ET 组接受戊酸雌二醇（1mg/天），AT 组每周进行 3 次中等强度的自行车运动。干预前和 6 个月后评估激素状态（血液分析）、最大心肺运动测试（VO₂峰值）和动态血压（24 小时、白天和夜间）。仅在参加有氧运动组的女性中观察到 VO₂峰值显著增加（+4.6±1.0mlkg⁻¹min⁻¹，P=0.00）。卵泡刺激素在 ET 组显著下降（-18.65±5.19pg/ml，P=0.00），同时循环雌激素增加（56.1±6.6pg/ml）。ET 组日间（P=0.01）和夜间收缩压（P=0.01）以及夜间舒张压（P=0.02）显著增加。然而，只有 ET-CO 组日间舒张压增加（+3.4±1.2mmHg，P=0.04），而其他组无变化。动态心率无显著影响。综上所述，有氧运动消除了子宫切除术后、健康、血压正常和绝经后女性中雌激素治疗引起的日间动态血压升高。
