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高血压老年患者在最大运动后心率恢复减弱。

Heart rate recovery after maximal exercise is blunted in hypertensive seniors.

作者信息

Best Stuart A, Bivens Tiffany B, Dean Palmer M, Boyd Kara N, Melyn Galbreath M, Okada Yoshiyuki, Carrick-Ranson Graeme, Fujimoto Naoki, Shibata Shigeki, Hastings Jeffrey L, Spencer Matthew D, Tarumi Takashi, Levine Benjamin D, Fu Qi

机构信息

Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas; and University of Texas Southwestern Medical Center, Dallas, Texas.

Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas; and.

出版信息

J Appl Physiol (1985). 2014 Dec 1;117(11):1302-7. doi: 10.1152/japplphysiol.00395.2014. Epub 2014 Oct 9.

Abstract

Abnormal heart rate recovery (HRR) after maximal exercise may indicate autonomic dysfunction and is a predictor for cardiovascular mortality. HRR is attenuated with aging and in middle-age hypertensive patients, but it is unknown whether HRR is attenuated in older-age adults with hypertension. This study compared HRR among 16 unmedicated stage 1 hypertensive (HTN) participants [nine men/seven women; 68 ± 5 (SD) yr; awake ambulatory blood pressure (BP) 149 ± 10/87 ± 7 mmHg] and 16 normotensive [control (CON)] participants (nine men/seven women; 67 ± 5 yr; 122 ± 4/72 ± 5 mmHg). HR, BP, oxygen uptake (V̇o2), cardiac output (Qc), and stroke volume (SV) were measured at rest, at two steady-state work rates, and graded exercise to peak during maximal treadmill exercise. During 6 min of seated recovery, the change in HR (ΔHR) was obtained every minute and BP every 2 min. In addition, HRR and R-R interval (RRI) recovery kinetics were analyzed using a monoexponential function, and the indexes (HRRI and RRII) were calculated. Maximum V̇o2, HR, Qc, and SV responses during exercise were not different between groups. ΔHR was significantly different (P < 0.001) between the HTN group (26 ± 8) and the CON group (36 ± 12 beats/min) after 1 min of recovery but less convincing at 2 min (P = 0.055). BP recovery was similar between groups. HRRI was significantly lower (P = 0.016), and there was a trend of lower RRII (P = 0.066) in the HTN group compared with the CON group. These results show that in older-age adults, HRR is attenuated further with the presence of hypertension, which may be attributable to an impairment of autonomic function.

摘要

最大运动后异常的心率恢复(HRR)可能表明自主神经功能障碍,并且是心血管死亡率的一个预测指标。HRR会随着年龄增长以及中年高血压患者而减弱,但尚不清楚在老年高血压患者中HRR是否也会减弱。本研究比较了16名未服药的1期高血压(HTN)参与者[9名男性/7名女性;68±5(标准差)岁;清醒动态血压(BP)149±10/87±7 mmHg]和16名血压正常的[对照(CON)]参与者(9名男性/7名女性;67±5岁;122±4/72±5 mmHg)之间的HRR。在静息状态、两个稳定工作率以及最大跑步机运动期间分级运动至峰值时,测量心率(HR)、血压(BP)、摄氧量(V̇o2)、心输出量(Qc)和每搏输出量(SV)。在坐位恢复的6分钟内,每分钟获取心率变化(ΔHR),每2分钟获取血压。此外,使用单指数函数分析HRR和R - R间期(RRI)恢复动力学,并计算指数(HRRI和RRII)。运动期间的最大V̇o2、HR、Qc和SV反应在两组之间没有差异。恢复1分钟后,HTN组(26±8)和CON组(36±12次/分钟)之间的ΔHR有显著差异(P<0.001),但在2分钟时差异不太明显(P = 0.055)。两组之间的血压恢复相似。与CON组相比,HTN组的HRRI显著更低(P = 0.016),并且RRII有更低的趋势(P = 0.066)。这些结果表明,在老年人中,高血压的存在会进一步使HRR减弱,这可能归因于自主神经功能受损。

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