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运动训练可改善年轻前期高血压患者的内皮功能。

Exercise training improves endothelial function in young prehypertensives.

机构信息

Malcom Randall VA Medical Center, GRECC, Gainesville, FL 32601, USA.

出版信息

Exp Biol Med (Maywood). 2013 Apr;238(4):433-41. doi: 10.1177/1535370213477600.

Abstract

Prehypertensives exhibit marked endothelial dysfunction, a risk factor for future cardiovascular morbidity and mortality. However, the ability of exercise to ameliorate endothelial dysfunction in prehypertensives is grossly underinvestigated. This prospective randomized and controlled study examined the separate effects of resistance and endurance training on conduit artery endothelial function in young prehypertensives. Forty-three unmedicated prehypertensive (systolic blood pressure [SBP]=120-139 mmHg; diastolic blood pressure [DBP]=80-89 mmHg) but otherwise healthy men and women and 15 normotensive matched time-controls (NMTC); n = 15) between 18 and 35 y of age met screening requirements and participated in the study. Prehypertensive subjects were randomly assigned to either a resistance exercise training (PHRT; n = 15), endurance exercise training (PHET; n = 13) or time-control group (PHTC; n = 15). The treatment groups performed exercise training three days per week for eight weeks. The control groups did not initiate exercise programs throughout the study. Flow mediated dilation (FMD) of the brachial artery, biomarkers of enodothelial function and peripheral blood pressure were evaluated before and after exercise intervention or time-matched control. PHRT and PHET reduced resting SBP (9.6 ± 3.6 and 11.9 ± 3.4 mmHg, respectively; P < 0.05) and DBP (8.0 ± 5.1 and 7.2 ± 3.4 mmHg, respectively; P < 0.05). Exercise training improved brachial artery FMD absolute diameter, percent dilation and normalized percent dilation by 30%, 34% and 19% for PHRT, P < 0.05; and by 54%, 63% and 75% for PHET, P < 0.05; respectively. PHRT and PHET increased plasma concentrations of 6-keto prostaglandin F1α (19% and 22%, respectively; P < 0.05), NO x (19% and 23%, respectively; P < 0.05), and reduced endothelin-1 by (16% and 24%, respectively; P < 0.01). This study provides novel evidence that resistance and endurance exercise separately have beneficial effects on resting peripheral blood pressure, brachial artery FMD and endothelial-derived vasoactive agents in young prehypertensives.

摘要

高血压前期患者表现出明显的内皮功能障碍,这是未来心血管发病率和死亡率的一个风险因素。然而,运动改善高血压前期患者内皮功能障碍的能力还远远没有得到充分研究。这项前瞻性随机对照研究考察了抗阻运动和耐力运动对年轻高血压前期患者的主要血管内皮功能的单独影响。43 名未经药物治疗的高血压前期患者(收缩压 [SBP]=120-139mmHg;舒张压 [DBP]=80-89mmHg)和 15 名血压正常的匹配时间对照组(NMTC);n=15)年龄在 18-35 岁之间,符合筛查要求并参与了研究。高血压前期患者被随机分为抗阻运动训练组(PHRT;n=15)、耐力运动训练组(PHET;n=13)或时间对照组(PHTC;n=15)。治疗组每周运动 3 天,共 8 周。对照组在整个研究过程中没有开始运动计划。在运动干预或时间匹配的对照组之前和之后评估肱动脉血流介导的扩张(FMD)、内皮功能的生物标志物和外周血压。PHRT 和 PHET 分别降低了静息 SBP(9.6±3.6 和 11.9±3.4mmHg;P<0.05)和 DBP(8.0±5.1 和 7.2±3.4mmHg;P<0.05)。运动训练使肱动脉 FMD 绝对直径、百分比扩张和归一化百分比分别增加 30%、34%和 19%,PHRT,P<0.05;增加 54%、63%和 75%,PHET,P<0.05;分别。PHRT 和 PHET 分别增加了 6-酮前列腺素 F1α(19%和 22%;P<0.05)、NOx(19%和 23%;P<0.05)的血浆浓度,分别减少了内皮素-1(16%和 24%;P<0.01)。这项研究提供了新的证据,表明抗阻运动和耐力运动分别对年轻高血压前期患者的静息外周血压、肱动脉 FMD 和内皮衍生的血管活性物质有有益的影响。

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