Caldarone Elisa, Severi Paolo, Lombardi Mario, D'Emidio Stefania, Mazza Andrea, Bendini Maria Grazia, Leggio Massimo
Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy.
Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital - Salus Infirmorum Clinic, Via della Lucchina 41, 00135 Rome, Italy.
Clin Hypertens. 2017 Jun 2;23:11. doi: 10.1186/s40885-017-0067-z. eCollection 2017.
The diagnostic and prognostic implication of exaggerated blood pressure response to exercise has been controversial, with opinions ranging from a benign process to a harbinger of potential cardiovascular morbidity. Nonetheless, lowering of blood pressure and prevention of hypertension is in first instance preferable by lifestyle changes, and many studies have shown the inverse association between physical activity level and the incidence of cardiovascular diseases suggesting low aerobic fitness as a strong predictor for future cardiovascular disease and all-cause mortality in both healthy and cardiovascular disease patients, including those with hypertension. Endothelial function, large artery stiffness and neurohormonal response are surely implicated both in the development of exaggerated blood pressure response to exercise and in the positive effect of physical exercise in the prevention and management of hypertension and cardiovascular disease in general. In their interesting and well documented review published in this issue Kim and Ha broadly described the possible pathophysiologic mechanisms of exaggerated blood pressure response to exercise and its clinical implications: in this regard, a very interesting issue could be represented by the role of exercise training. In fact, there is an the ample evidence in the literature that physical activity could positively affect endothelial function, arterial stiffness, neurohormonal response and finally blood pressure levels both in healthy men and in hypertensive patients and so should be considered a very important element in the prevention and management of cardiovascular disease.
运动时血压反应过度的诊断和预后意义一直存在争议，观点从一个良性过程到潜在心血管疾病发病的先兆不等。尽管如此，首先通过生活方式改变来降低血压和预防高血压是更可取的，许多研究表明身体活动水平与心血管疾病发病率之间存在负相关，这表明有氧运动能力低是健康人和心血管疾病患者（包括高血压患者）未来心血管疾病和全因死亡率的有力预测指标。内皮功能、大动脉僵硬度和神经激素反应肯定与运动时血压反应过度的发生以及体育锻炼对高血压和心血管疾病总体预防和管理的积极作用都有关。在本期发表的一篇有趣且有充分文献依据的综述中，Kim和Ha广泛描述了运动时血压反应过度的可能病理生理机制及其临床意义：在这方面，运动训练的作用可能是一个非常有趣的问题。事实上，文献中有充分证据表明，身体活动对健康男性和高血压患者的内皮功能、动脉僵硬度、神经激素反应以及最终的血压水平都有积极影响，因此应被视为心血管疾病预防和管理中的一个非常重要的因素。
