Laboratory of Experimental Hypertension, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil.
Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, MA, Brazil.
Adv Exp Med Biol. 2017;1000:65-84. doi: 10.1007/978-981-10-4304-8_5.
Hypertension is a worldwide prevalent disease, mostly manifested as its primary ethiology, characterized by a chronic, multifactorial, asymptomatic, and usually incurable state. It is estimated that more than one billion of the world population is hypertensive. Also, hypertension is the main cause of the two most frequent causes of death worldwide: myocardial infarction and stroke. Due to the necessity of the cardiovascular system to manage chronically increased levels of blood pressure, hypertension causes severe alterations in multiple organs, as the heart, vessels, kidneys, eyes and brain, thus increasing the risk of health complications. The heart is the main target organ and suffers several adaptations to compensate the increased blood pressure levels; nevertheless, long-term adaptations without proper control are extremely harmful to cardiovascular health. On the other hand, hypertension is a modifiable risk factor and its adequate control is highly dependent on lifestyle. Pharmacological treatment is of great success when adherence is high. Several classes of antihypertensive drugs are prescribed and can effectively maintain blood pressure within acceptable levels. However, non-pharmacological methods, as diet and exercise training, can not only optimize the treatment but also prevent or postpone hypertension development as well as its complications, acting as important complements to the ideal control of elevated blood pressure, and bringing together benefits beyond blood pressure decrease, as a general health status improvement and increased quality of life. There is consistent evidence that regular exercise training promotes several benefits when properly prescribed and practised, acting as "medicine" for dozens of chronic diseases. The effects of exercise training in blood pressure levels and in its mechanisms of control are of clinical relevance and efficacy. This chapter will describe the classical and recent results on the beneficial effects of different modalities of exercise training in the cardiovascular system of human primary hypertension, focusing on the mechanisms influenced by exercise training which help to decrease blood pressure and improve the cardiovascular system.
高血压是一种全球性的多发病，主要表现为原发性病因，其特征为慢性、多因素、无症状且通常无法治愈。据估计，全球有超过 10 亿人口患有高血压。此外，高血压是全球两种最常见死因（心肌梗死和中风）的主要原因。由于心血管系统需要长期应对血压升高，高血压会导致心脏、血管、肾脏、眼睛和大脑等多个器官发生严重改变，从而增加健康并发症的风险。心脏是主要的靶器官，会发生多种适应性变化来代偿血压升高；然而，长期的适应性变化如果没有得到适当的控制，对心血管健康是极其有害的。另一方面，高血压是一个可改变的风险因素，其适当控制高度依赖于生活方式。药物治疗在患者高度遵医嘱时效果显著。多种降压药物被开处方并能有效地将血压维持在可接受的水平。然而，非药物方法，如饮食和运动训练，不仅可以优化治疗效果，还可以预防或推迟高血压的发展及其并发症，作为理想控制高血压的重要补充，除了降低血压外，还能带来一般健康状况改善和生活质量提高等益处。有一致的证据表明，规律的运动训练在适当的规定和实践下可以带来多种益处，它可以作为数十种慢性疾病的“药物”。运动训练对血压水平及其控制机制的影响具有临床相关性和疗效。本章将描述不同运动训练方式对原发性高血压患者心血管系统的有益影响的经典和最新研究结果，重点介绍受运动训练影响的有助于降低血压和改善心血管系统的机制。
