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高血压患者父母的血压正常后代在等长体育锻炼期间的外周血管阻力损伤

Peripheral Vascular Resistance Impairment during Isometric Physical Exercise in Normotensive Offspring of Hypertensive Parents.

作者信息

Portela Natália, Amaral Josária Ferraz, Mira Pedro Augusto de Carvalho, Souza Livia Victorino de, Martinez Daniel Godoy, Laterza Mateus Camaroti

机构信息

Unidade de Investigação Cardiovascular e Fisiologia do Exercício - Faculdade de Educação Física e Desportos - Universidade Federal de Juiz de Fora, Juiz de Fora, MG - Brazil.

Disciplina de Nefrologia - Faculdade de Medicina - Universidade Federal de São Paulo, São Paulo, SP - Brazil.

出版信息

Arq Bras Cardiol. 2017 Jul 10;109(2):0. doi: 10.5935/abc.20170096.

DOI:10.5935/abc.20170096
PMID:28700018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5576114/
Abstract

BACKGROUND

: A family history of hypertension is associated with vascular and autonomic abnormalities, as well as an impaired neurohemodynamic response to exercise.

OBJECTIVE

: To test the hypothesis that normotensive individuals with a family history of hypertension present an impaired peripheral vascular resistance response to exercise.

METHODS

: The study included 37 normotensive volunteers of both sexes who were sedentary, eutrophic, and nonsmokers, comprising 23 with (FH+; 24 ± 3 years) and 14 without (FH-; 27 ± 5 years) a family history of hypertension. Blood pressure, heart rate (DIXTAL®), forearm blood flow (Hokanson®), and peripheral vascular resistance were simultaneously measured for 3 minutes during rest and, subsequently, for 3 minutes during an isometric exercise at 30% of maximal voluntary contraction (Jamar®).

RESULTS

: At rest, the FH+ and FH- groups present similar mean blood pressure (83 ± 7 versus 83 ± 5 mmHg, p = 0.96), heart rate (69 ± 8 bpm versus 66 ± 7 bpm, p = 0.18), forearm blood flow (3 ± 1 mL/min/100 mL versus 2.7 ± 1 mL/min/100 mL, p = 0.16), and peripheral vascular resistance (30 ± 9 units versus 34±9 units, p = 0.21), respectively. Both groups showed a significant and similar increase in mean blood pressure (∆ = 15 ± 7 mmHg versus 14 ± 7 mmHg, p = 0.86), heart rate (∆ = 12 ± 8 bpm versus 13 ± 7 bpm, p = 0.86), and forearm blood flow (∆ = 0.8 ± 1.2 mL/min/100 mL versus 1.4 ± 1.1 mL/min/100 mL, p = 0.25), respectively, during exercise. However, individuals in the FH+ group showed no reduction in peripheral vascular resistance during exercise, which was observed in the FH- group (∆ = -0.4 ± 8.6 units versus -7.2 ± 6.3 units, p = 0.03).

CONCLUSION

: Normotensive individuals with a family history of hypertension present an impaired peripheral vascular resistance response to exercise.

FUNDAMENTO

: O histórico familiar para hipertensão arterial está relacionado a anormalidades vasculares e autonômicas, bem como disfunções no comportamento neuro-hemodinâmico durante o exercício físico.

OBJETIVO

: Testar a hipótese de que indivíduos normotensos com histórico familiar de hipertensão arterial apresentam resposta prejudicada da resistência vascular periférica durante o exercício físico.

MÉTODOS:: Foram avaliados 37 normotensos de ambos os sexos, sedentários, eutróficos e não tabagistas, sendo 23 com histórico familiar positivo (HF+, 24 ± 3 anos) e 14 com histórico familiar negativo (HF-, 27 ± 5 anos) para hipertensão arterial. Foram identificados pressão arterial, frequência cardíaca (DIXTAL®), fluxo sanguíneo muscular do antebraço e resistência vascular periférica local (Hokanson®) por 3 minutos durante o repouso e, em seguida, 3 minutos durante exercício isométrico de preensão palmar a 30% da contração voluntária máxima (Jamar®).

RESULTADOS

: Em repouso, os grupos HF+ e HF- apresentaram valores semelhantes de pressão arterial média (83 ± 7 mmHg versus 83 ± 5 mmHg, p = 0,96), frequência cardíaca (69 ± 8 bpm versus 66 ± 7 bpm, p = 0,18), fluxo sanguíneo muscular (3 ± 1 mL/min/199 mL versus 2,7 ± 1 mL/min/100 mL, p = 0,16) e resistência vascular periférica (30 ± 9 unidades versus 34 ± 9 unidades, p = 0,21), respectivamente. Durante o exercício, HF+ e HF- mostraram aumento significativo e semelhante da pressão arterial média (∆ = 15 ± 7 mmHg versus 14 ± 7 mmHg, p = 0,86), frequência cardíaca (∆ = 12 ± 8 bpm versus 13 ± 7 bpm, p = 0,86) e fluxo sanguíneo muscular (∆ = 0,8 ± 1,2 mL/min/100 mL versus 1,4 ± 1,1 mL/min/100 mL, p = 0,25), respectivamente. Entretanto, no grupo HF+ não houve redução significativa da resistência vascular periférica durante o exercício, fato que ocorreu no grupo HF- (∆ = -0,4 ± 8,6 unidades versus -7,2 ± 6,3 unidades, p = 0,03).

CONCLUSÃO:: Indivíduos normotensos com histórico familiar de hipertensão arterial apresentam resposta prejudicada da resistência vascular periférica durante o exercício físico.

摘要

背景

高血压家族史与血管及自主神经异常有关,同时也与运动时神经血流动力学反应受损有关。

目的

检验以下假设:有高血压家族史的血压正常个体在运动时外周血管阻力反应受损。

方法

该研究纳入了37名久坐、营养良好且不吸烟的男女血压正常志愿者,其中23名有高血压家族史(FH+;24±3岁),14名无高血压家族史(FH-;27±5岁)。在静息状态下同时测量3分钟的血压、心率(DIXTAL®)、前臂血流量(Hokanson®)和外周血管阻力,随后在最大自主收缩量30%的等长运动(Jamar®)期间再测量3分钟。

结果

静息时,FH+组和FH-组的平均血压(83±7 mmHg对83±5 mmHg,p = 0.96)、心率(69±8次/分钟对66±7次/分钟,p = 0.18)、前臂血流量(3±1 mL/分钟/100 mL对2.7±1 mL/分钟/100 mL,p = 0.16)和外周血管阻力(30±9单位对34±9单位,p = 0.21)相似。两组在运动期间平均血压(Δ = 15±7 mmHg对14±7 mmHg,p = 0.86)、心率(Δ = 12±8次/分钟对13±7次/分钟,p = 0.86)和前臂血流量(Δ = 0.8±1.2 mL/分钟/100 mL对1.4±1.1 mL/分钟/100 mL,p = 0.25)均有显著且相似的升高。然而,FH+组个体运动期间外周血管阻力未降低,而FH-组有此现象(Δ = -0.4±8.6单位对-7.2±6.3单位;p = 0.03)。

结论

有高血压家族史的血压正常个体在运动时外周血管阻力反应受损。

基础

动脉高血压家族史与血管和自主神经异常有关,以及在体育锻炼期间神经血液动力学行为的功能障碍。

目的

测试以下假设:有动脉高血压家族史的血压正常个体在体育锻炼期间外周血管阻力反应受损。

方法

评估了37名男女血压正常者,他们久坐、营养良好且不吸烟,其中23名有高血压家族史阳性(HF+,24±3岁),14名有高血压家族史阴性(HF-,27±5岁)。在静息状态下测量3分钟的动脉血压、心率(DIXTAL®)、前臂肌肉血流量和局部外周血管阻力(Hokanson®),然后在最大自愿收缩量30%的等长握力运动(Jamar®)期间再测量3分钟。

结果

静息时,HF+组和HF-组的平均动脉血压值相似(83±7 mmHg对83±5 mmHg,p = 0.96)、心率(69±8次/分钟对66±7次/分钟,p = 0.18)、肌肉血流量(3±1 mL/分钟/199 mL对2.7±1 mL/分钟/100 mL,p = 0.16)和外周血管阻力(30±9单位对34±9单位,p = 0.21)。运动期间,HF+组和HF-组的平均动脉血压均有显著且相似的升高(Δ = 15±7 mmHg对14±7 mmHg,p = 0.86)、心率(Δ = 12±8次/分钟对13±7次/分钟,p = 0.86)和肌肉血流量(Δ = 0.8±1.2 mL/分钟/100 mL对1.4±1.1 mL/分钟/100 mL,p = 0.25)。然而,HF+组在运动期间外周血管阻力没有显著降低,而HF-组出现了这种情况(Δ = -0.4±8.6单位对-7.2±6.3单位,p = 0.03)。

结论

有动脉高血压家族史的血压正常个体在体育锻炼期间外周血管阻力反应受损。

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