Pagonas Nikolaos, Vlatsas Stergios, Bauer Frederic, Seibert Felix S, Zidek Walter, Babel Nina, Schlattmann Peter, Westhoff Timm H
aMedical Department I, Marien Hospital Herne, University Hospital of the Ruhr University of Bochum, Bochum bDepartment of Cardiology and Angiology, Medical University Brandenburg cDepartment of Nephrology, Charité Campus Benjamin Franklin, Berlin dDepartment of Medical Statistics, Informatics and Documentation, Jena University Hospital, Jena, Germany.
J Hypertens. 2017 Nov;35(11):2199-2206. doi: 10.1097/HJH.0000000000001445.
Aerobic dynamic exercise reduces blood pressure (BP) and is broadly recommended by current American and European hypertension guidelines. Isometric exercise is currently not recommended, since data from only a few studies are available. We compare for the first time the effects of isometric handgrip training and aerobic exercise in a randomized controlled trial.
A total of 75 hypertensive patients were randomized to one of the following 12-week programmes: Isometric handgrip training five times weekly (two contractions of 2 min at 30% of maximal power with each arm); 'Sham-handgrip training' five times weekly (two contractions of 2 min at 5% of maximal power with each arm); Aerobic exercise training of 30 min three to five times per week. All patients underwent office BP measurement, 24-h ambulatory BP measurement and noninvasive assessment of arterial compliance and systemic vascular resistance at baseline and after 12 weeks.
Baseline epidemiological and hemodynamic characteristics did not differ between groups. Aerobic exercise led to a significant reduction of systolic 24-h BP (P = 0.025), office SBP (P = 0.03), systemic vascular resistance (P = 0.001) and small artery elasticity index (P = 0.005). There were no statistical significant changes of these parameters in the isometric exercise and the 'sham exercise' groups (P > 0.05 each).
Isometric handgrip training, performed according to a typical protocol, did not reduce BP in hypertensive patients. Aerobic exercise, even as an uncontrolled and unsupervised exercise regimen, led to a significant reduction of ambulatory and office BP.
有氧动态运动可降低血压（BP），目前被美国和欧洲的高血压指南广泛推荐。等长运动目前不被推荐，因为仅有少数研究的数据。我们在一项随机对照试验中首次比较了等长握力训练和有氧运动的效果。
总共75名高血压患者被随机分配到以下12周方案之一：每周进行5次等长握力训练（每只手臂以最大力量的30%进行2分钟的两次收缩）；每周进行5次“假握力训练”（每只手臂以最大力量的5%进行2分钟的两次收缩）；每周进行3至5次30分钟的有氧运动训练。所有患者在基线和12周后均接受诊室血压测量、24小时动态血压测量以及动脉顺应性和全身血管阻力的无创评估。
各小组之间的基线流行病学和血流动力学特征无差异。有氧运动导致24小时收缩压显著降低（P = 0.025）、诊室收缩压（P = 0.03）、全身血管阻力（P = 0.001）和小动脉弹性指数（P = 0.005）。等长运动组和“假运动”组的这些参数无统计学显著变化（每组P>0.05）。
按照典型方案进行的等长握力训练并未降低高血压患者的血压。有氧运动，即使作为一种无控制和无监督的运动方案，也导致动态血压和诊室血压显著降低。
