Malcom Randall VA Medical Center, Geriatric Research Education and Clinical Center, Gainesville, Florida.
Am J Hypertens. 2013 Sep;26(9):1093-102. doi: 10.1093/ajh/hpt080. Epub 2013 Jun 4.
Large artery stiffness is a major risk factor for the development of hypertension and cardiovascular disease. Persistent prehypertension accelerates the progression of arterial stiffness.
Forty-three unmedicated prehypertensive (systolic blood pressure (SBP) = 120-139 mm Hg or diastolic blood pressure (DBP) = 80-89 mm Hg) men and women and 15 normotensive time-matched control subjects (NMTCs; n = 15) aged 18-35 years of age met screening requirements and participated in the study. Prehypertensive subjects were randomly assigned to a resistance exercise training (PHRT; n = 15), endurance exercise training (PHET; n = 13) or time-control group (PHTC; n = 15). Treatment groups performed exercise training 3 days per week for 8 weeks. Pulse wave analysis, pulse wave velocity (PWV), and central and peripheral blood pressures were evaluated before and after exercise intervention or time-matched control.
PHRT and PHET reduced resting SBP by 9.6±3.6mm Hg and 11.9±3.4mm Hg, respectively, and DBP by 8.0±5.1mm Hg and 7.2±3.4mm Hg, respectively (P < 0.05). PHRT and PHET decreased augmentation index (AIx) by 7.5% ± 2.8% and 8.1% ± 3.2% (P < 0.05), AIx@75 by 8.0% ± 3.2% and 9.2% ± 3.8% (P < 0.05), and left ventricular wasted pressure energy, an index of extra left ventricular myocardial oxygen requirement due to early systolic wave reflection, by 573±161 dynes s/cm(2) and 612±167 dynes s/cm(2) (P < 0.05), respectively. PHRT and PHET reduced carotid-radial PWV by 1.02±0.32 m/sec and 0.92±0.36 m/sec (P < 0.05) and femoral-distal PWV by 1.04±0.31 m/sec and 1.34±0.33 m/sec (P < 0.05), respectively. No significant changes were observed in the time-control groups.
This study suggests that both resistance and endurance exercise alone effectively reduce peripheral arterial stiffness, central blood pressures, augmentation index, and myocardial oxygen demand in young prehypertensive subjects.
大动脉僵硬是高血压和心血管疾病发展的主要危险因素。持续性的前期高血压会加速动脉僵硬的发展。
43 名未经药物治疗的前期高血压男性和女性（收缩压（SBP）= 120-139mmHg 或舒张压（DBP）= 80-89mmHg）以及 15 名年龄在 18-35 岁的血压正常的匹配对照组（NMTC；n=15）符合筛选要求并参与了研究。前期高血压患者被随机分为阻力运动训练组（PHRT；n=15）、耐力运动训练组（PHET；n=13）或时间对照组（PHTC；n=15）。治疗组每周进行 3 天运动训练，共 8 周。在运动干预或时间匹配的对照组前后评估脉搏波分析、脉搏波速度（PWV）以及中心和外周血压。
PHRT 和 PHET 分别降低了静息 SBP 9.6±3.6mmHg 和 11.9±3.4mmHg，DBP 8.0±5.1mmHg 和 7.2±3.4mmHg（P<0.05）。PHRT 和 PHET 分别降低了 7.5%±2.8%和 8.1%±3.2%的增强指数（AIx）（P<0.05）、AIx@75 8.0%±3.2%和 9.2%±3.8%（P<0.05）和左心室浪费压力能量，这是由于早期收缩波反射引起的额外左心室心肌氧需求的指标，分别降低了 573±161 达因 s/cm²和 612±167 达因 s/cm²（P<0.05）。PHRT 和 PHET 分别降低了颈动脉-桡动脉 PWV 1.02±0.32 m/sec 和 0.92±0.36 m/sec（P<0.05）和股动脉-远端 PWV 1.04±0.31 m/sec 和 1.34±0.33 m/sec（P<0.05）。时间对照组没有观察到显著变化。
这项研究表明，单独进行阻力运动和耐力运动都能有效降低年轻前期高血压患者的外周动脉僵硬、中心血压、增强指数和心肌氧需求。
