Department of Physiology, Faculty of Medicine, University of Valencia and Fundacion Investigacion Hospital Clinico Universitario de Valencia, Instituto de Investigacion INCLIVA, Valencia, Spain.
Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, United States.
Curr Pharm Des. 2017;23(31):4650-4657. doi: 10.2174/1381612823666170710151942.
It was initially assumed that heart rate and arterial blood pressure were modulated by normal respiration and muscle contraction. The arterial baroreflex, an inverse relationship between blood pressure and heart rate, was later reported. Nonetheless, it was then assumed that those responses involved vagal modulation. We summarize available evidence on the modulation of heart rate by acute or chronic aerobic exercise as well as its potential implications on blood pressure (BP) control. Numerous studies have tried to clarify whether aerobic exercise modifies neurally-mediated vasoconstriction, but they report contradictory results. In view of these incongruities, the aim of this narrative review is to summarize available evidence on the modulation of heart rate by acute or chronic aerobic exercise as well as its potential implications on BP control. We mainly focus on the effects of aerobic exercise in both heart rate and blood pressure. Heart rate and heart rate variability have been indistinctly considered similar metrics, but they have completely different meanings when properly used. Both are risk markers in cardiac disease, whereas heart rate variability is also an index of sympathovagal modulation of heart rate. On the other hand, heart rate recovery has been also used as an index for mirroring both cardiovascular fitness and autonomic function, and can be used as a measure of vagal reactivation. Importantly, it is now wellknown that a reduced rate of heart rate recovery represents a powerful predictor of overall mortality. In this review, due to its complexity, we have included studies in which any of these three parameters have been analyzed.
最初人们认为心率和动脉血压受到正常呼吸和肌肉收缩的调节。后来报道了动脉压力反射，即血压与心率之间的反比关系。尽管如此，当时仍假设这些反应涉及迷走神经调节。我们总结了急性或慢性有氧运动对心率的调节及其对血压（BP）控制的潜在影响的现有证据。许多研究试图阐明有氧运动是否改变了神经介导的血管收缩，但他们报告了相互矛盾的结果。鉴于这些不一致，本叙述性综述的目的是总结急性或慢性有氧运动对心率的调节及其对 BP 控制的潜在影响的现有证据。我们主要关注有氧运动对心率和血压的影响。心率和心率变异性一直被认为是相似的指标，但在正确使用时它们具有完全不同的含义。两者都是心脏病的风险标志物，而心率变异性也是心率的交感神经和副交感神经调制的指标。另一方面，心率恢复也被用作反映心血管健康和自主功能的指标，并且可以用作迷走神经再激活的测量。重要的是，现在众所周知，心率恢复率降低是总死亡率的有力预测指标。在本综述中，由于其复杂性，我们纳入了分析其中任何一个参数的研究。
