Ling Chenyi, Diaz Keith M, Kretzschmar Jan, Feairheller Deborah L, Sturgeon Kathleen M, Perkins Amanda, Veerabhadrappa Praveen, Williamson Sheara T, Lee Hojun, Grimm Heather, Babbitt Dianne M, Brown Michael D
aDepartment of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois bDepartment of Kinesiology, College of Health Professions, Temple University cInstitute of Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia dDepartment of Health and Exercise Physiology, Ursinus College, Collegeville eDepartment of Exercise Science, College of Education, Shippensburg University, Shippensburg, Pennsylvania fDepartment of Medicine, Columbia University, Medical Center, New York, New York gDepartment of Kinesiology, Missouri State University, Springfield, Missouri hDepartment of Biology, Notre Dame University of Maryland, Baltimore, Maryland, USA.
Blood Press Monit. 2014 Dec;19(6):353-8. doi: 10.1097/MBP.0000000000000075.
The effects of exercise training on nocturnal blood pressure (BP) dipping status remain unclear. African Americans have the highest prevalence of nondippers compared with other racial/ethnic populations. In this 6-month study we tested the hypothesis that long-term aerobic exercise training would increase the levels of nocturnal BP dipping in African American nondippers.
We recruited African Americans who were nondiabetic, nonsmoking, and free from cardiovascular and renal disease. For this analysis, only African Americans with a nondipping profile, defined as those with the absence of a nocturnal decline in systolic or diastolic BP (<10% of daytime values), which was determined by ambulatory BP monitoring, were chosen. A pre-post design was used, with baseline and final evaluation including office blood pressure measurement, 24-h ambulatory blood pressure monitoring, fasted blood sampling, and graded exercise testing. Participants engaged in 6 months of supervised aerobic exercise training (AEXT). Following the AEXT intervention, there were significant increases in systolic BP dipping (baseline: 5.8±3.9% vs. final: 9.4±6.1%, P=0.0055) and pulse pressure dipping (baseline: -3.1±6.6% vs. final: 5.0±12.8%, P=0.0109). Of the 18 participants with a nondipping profile at baseline, eight were nonclassified as nondippers after the AEXT intervention. There were no significant changes in office systolic BP/diastolic BP values following the AEXT intervention.
This study suggests that the nondipping pattern of ambulatory BP can be improved by chronic AEXT in African American nondippers, regardless of a change in the 24-h average BP. This finding may be clinically important because of the target organ implication of nondipping nocturnal BP.
运动训练对夜间血压（BP）下降状态的影响尚不清楚。与其他种族/族裔人群相比，非裔美国人非勺型血压的患病率最高。在这项为期6个月的研究中，我们检验了以下假设：长期有氧运动训练会增加非裔美国非勺型血压者的夜间血压下降水平。
我们招募了非糖尿病、不吸烟且无心血管和肾脏疾病的非裔美国人。对于本分析，仅选择那些通过动态血压监测确定为非勺型血压模式（定义为收缩压或舒张压夜间无下降<日间值的10%）的非裔美国人。采用前后设计，基线和最终评估包括诊室血压测量、24小时动态血压监测、空腹采血和分级运动试验。参与者进行了6个月的有监督的有氧运动训练（AEXT）。AEXT干预后，收缩压下降幅度显著增加（基线：5.8±3.9% vs.最终：9.4±6.1%，P=0.0055），脉压下降幅度也显著增加（基线：-3.1±6.6% vs.最终：5.0±12.8%，P=0.0109）。在基线时具有非勺型血压模式的18名参与者中，有8名在AEXT干预后不再被归类为非勺型血压者。AEXT干预后，诊室收缩压/舒张压值无显著变化。
本研究表明，慢性AEXT可改善非裔美国非勺型血压者的动态血压非勺型模式，而与24小时平均血压的变化无关。由于夜间非勺型血压对靶器官有影响，这一发现可能具有临床重要性。
