Sosner P, Gremeaux V, Bosquet L, Herpin D
Service de cardiologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France; Laboratoire MOVE (EA 6314), université de Poitiers, 8, allée Jean-Monnet, 86000 Poitiers, France.
Pôle rééducation-réadaptation, centre hospitalier universitaire de Dijon, 23, rue Gaffarel, 21000 Dijon, France; Plateforme d'investigation technologique, CIC Inserm 1432, CHU de Dijon, 23, rue Gaffarel, 21079 Dijon, France; Inserm U1093 « cognition, action, et plasticité sensorimotrice », 21078 Dijon, France.
Ann Cardiol Angeiol (Paris). 2014 Jun;63(3):197-203. doi: 10.1016/j.ancard.2014.05.003. Epub 2014 Jun 2.
High blood pressure is a frequent pathology with many cardiovascular complications. As highlighted in guidelines, the therapeutic management of hypertension relies on non-pharmacological measures, which are diet and regular physical activity, but both patients and physicians are reluctant to physical activity prescription. To acquire the conviction that physical activity is beneficial, necessary and possible, we can take into account some fundamental and clinical studies, as well as the feedback of our clinical practice. Physical inactivity is a major risk factor for cardiovascular morbidity and mortality, and hypertension contributes to increase this risk. Conversely, regular practice of physical activity decreases very significantly the risk by up to 60%. The acute blood pressure changes during exercise and post-exercise hypotension differs according to the dynamic component (endurance or aerobic and/or strength exercises), but the repetition of the sessions leads to the chronic hypotensive benefit of physical activity. Moreover, physical activity prescription must take into account the assessment of global cardiovascular risk, the control of the hypertension, and the opportunities and desires of the patient in order to promote good adherence and beneficial lifestyle change.
高血压是一种常见病症,会引发多种心血管并发症。正如指南中所强调的,高血压的治疗管理依赖于非药物措施,即饮食和规律的体育活动,但患者和医生都不太愿意开具体育活动处方。为了确信体育活动有益、必要且可行,我们可以参考一些基础研究和临床研究,以及我们临床实践的反馈。缺乏体育活动是心血管疾病发病和死亡的主要风险因素,而高血压会增加这种风险。相反,定期进行体育活动可将风险显著降低多达60%。运动期间的急性血压变化和运动后低血压因运动的动态成分(耐力或有氧运动和/或力量训练)而异,但重复训练会带来体育活动的慢性降压益处。此外,体育活动处方必须考虑整体心血管风险评估、高血压的控制以及患者的机会和意愿,以促进良好的依从性和有益的生活方式改变。