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晨练与晚间有氧训练对高血压治疗患者血压的影响

Morning versus Evening Aerobic Training Effects on Blood Pressure in Treated Hypertension.

机构信息

Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, BRAZIL.

Department of Nephrology, Medical School, University of São Paulo, São Paulo, BRAZIL.

出版信息

Med Sci Sports Exerc. 2019 Apr;51(4):653-662. doi: 10.1249/MSS.0000000000001852.

DOI:10.1249/MSS.0000000000001852
PMID:30489494
Abstract

INTRODUCTION

The acute blood pressure (BP) decrease is greater after evening than morning exercise, suggesting that evening training (ET) may have a greater hypotensive effect.

OBJECTIVE

This study aimed to compare the hypotensive effect of aerobic training performed in the morning versus evening in treated hypertensives.

METHODS

Fifty treated hypertensive men were randomly allocated to three groups: morning training (MT), ET, and control (C). Training groups cycled for 45 min at moderate intensity (progressing from the heart rate of the anaerobic threshold to 10% below the heart rate of the respiratory compensation point), while C stretched for 30 min. Interventions were conducted 3 times per week for 10 wk. Clinic and ambulatory BP and hemodynamic and autonomic mechanisms were evaluated before and after the interventions. Clinic assessments were performed in the morning (7:00-9:00 AM) and evening (6:00-8:00 PM). Between-within ANOVA was used (P ≤ 0.05).

RESULTS

Only ET decreased clinic systolic BP differently from C and MT (morning assessment -5 ± 6 mm Hg and evening assessment -8 ± 7 mm Hg, P < 0.05). Only ET reduced 24 h and asleep diastolic BP differently from C and MT (-3 ± 5 and -3 ± 4 mm Hg, respectively, P < 0.05). Systemic vascular resistance decreased from C only in ET (P = 0.03). Vasomotor sympathetic modulation decreased (P = 0.001) and baroreflex sensitivity (P < 0.02) increased from C in both training groups with greater changes in ET than MT.

CONCLUSIONS

In treated hypertensive men, aerobic training performed in the evening decreased clinic and ambulatory BP due to reductions in systemic vascular resistance and vasomotor sympathetic modulation. Aerobic training conducted at both times of day increases baroreflex sensitivity, but with greater after ET.

摘要

简介

与晨练相比,晚间运动后血压(BP)下降幅度更大,这表明晚间训练(ET)可能具有更大的降压作用。

目的

本研究旨在比较清晨和晚间有氧运动对高血压患者的降压效果。

方法

将 50 名接受治疗的高血压男性患者随机分为三组:晨练(MT)、ET 和对照组(C)。训练组以中等强度进行 45 分钟的骑行(从无氧阈心率进展到低于呼吸补偿点心率 10%),而 C 组则进行 30 分钟的拉伸运动。干预措施每周进行 3 次,共 10 周。在干预前后评估诊所和动态血压以及血流动力学和自主神经机制。诊所评估在早上(7:00-9:00 AM)和晚上(6:00-8:00 PM)进行。采用组间方差分析(P ≤ 0.05)。

结果

只有 ET 与 C 和 MT 相比,不同程度地降低了诊所收缩压(早晨评估-5 ± 6 mmHg,晚上评估-8 ± 7 mmHg,P < 0.05)。只有 ET 与 C 和 MT 相比,不同程度地降低了 24 小时和睡眠舒张压(分别为-3 ± 5 和-3 ± 4 mmHg,P < 0.05)。只有 ET 降低了系统性血管阻力(P = 0.03)。血管运动交感神经调节减弱(P = 0.001),而压力反射敏感性增加(P < 0.02),ET 组的变化大于 MT 组。

结论

在接受治疗的高血压男性中,晚间进行有氧运动可降低诊所和动态血压,这归因于系统性血管阻力和血管运动交感神经调节的降低。在一天中的两个时间进行有氧运动均可增加压力反射敏感性,但 ET 后增加更多。

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