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功能性状态在高血压老年患者中得到改善:降压治疗联合多组分运动干预的长期效果。

Functional status improves in hypertensive older adults: the long-term effects of antihypertensive therapy combined with multicomponent exercise intervention.

机构信息

Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra, Estádio Universitário de Coimbra, Pavilhão 3, 3000, Coimbra, Portugal.

Departamento de Ciências do Desporto, Universidade da Beira Interior, Covilhã, Portugal.

出版信息

Aging Clin Exp Res. 2018 Dec;30(12):1483-1495. doi: 10.1007/s40520-018-0925-x. Epub 2018 Mar 6.

Abstract

BACKGROUND

The increasing prevalence of functionally-limited hypertensive individuals highlights the need for interventions to reduce the burden of hypertension-aging-disability and to maximize the chances of healthy aging.

AIM

This study aims to compare the effects of multicomponent exercise and different pharmacological treatments on functional status and cardiovascular risk outcomes in hypertensive older adults with comorbidities.

METHODS

Participants (n = 96) engage in a 3 days/week multicomponent (aerobic + resistance) exercise program and for one of the following three conditions: (1) thiazide-related diuretics (TDs; n = 33, 69.9 ± 9.5 years); (2) calcium channel blockers (CCBs; n = 23, 67.0 ± 9.0 years); (3) and β-blockers (βBs; n = 40, 65.6 ± 7.2 years) medication. Baseline and 2-year follow-up evaluations included the Senior Fitness Test battery, anthropometrics and hemodynamic profile, health-related quality of life (HRQoL; Short-Form Health Survey 36) and health history questionnaires.

RESULTS

All groups have significantly improved the physical functional status; particularly upper and lower body strength and aerobic endurance and systolic blood pressure. The TDs and βBs groups have diminished the waist circumference and body mass. The CCBs decreased total cholesterol (P = 0.028), perceived better physical functioning, physical component score but also augmented bodily pain (P < 0.05). The βB group decreased triglycerides (P = 0.013). No group differences were found.

CONCLUSION

Multicomponent exercise training has improved functional status regardless of the antihypertensive medication options. Hypertensive older adults should add exercise training to pharmacological antihypertensive therapy to reduce the rate of physical disability.

摘要

背景

功能受限的高血压患者日益增多,这凸显了减少高血压-衰老-残疾负担、最大限度提高健康老龄化机会的干预措施的必要性。

目的

本研究旨在比较多成分运动和不同药物治疗对患有合并症的老年高血压患者功能状态和心血管风险结果的影响。

方法

参与者(n=96)每周进行 3 天的多成分(有氧运动+阻力运动)锻炼计划,并接受以下三种治疗之一:(1)噻嗪类相关利尿剂(TDs;n=33,69.9±9.5 岁);(2)钙通道阻滞剂(CCBs;n=23,67.0±9.0 岁);(3)β受体阻滞剂(βBs;n=40,65.6±7.2 岁)。基线和 2 年随访评估包括高级体能测试、人体测量学和血液动力学参数、健康相关生活质量(Short-Form Health Survey 36)和健康史问卷。

结果

所有组的身体功能状态均显著改善;特别是上肢和下肢力量、有氧耐力和收缩压。TDs 和 βBs 组的腰围和体重均有所下降。CCBs 降低了总胆固醇(P=0.028),改善了身体功能感知,提高了身体成分评分,但也增加了身体疼痛(P<0.05)。βB 组降低了甘油三酯(P=0.013)。组间无差异。

结论

多成分运动训练可改善功能状态,无论选择何种降压药物。高血压老年患者应将运动训练加入到降压药物治疗中,以降低身体残疾的发生率。

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