Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Can J Cardiol. 2018 Dec;34(12):1641-1647. doi: 10.1016/j.cjca.2018.09.013. Epub 2018 Oct 5.
Heated water-based exercise (HEx) promotes a marked reduction of blood pressure (BP), but it is not entirely clear whether its effects on BP persist after cessation of HEx.
We analyzed the effects of cessation of HEx on 24-hour ambulatory BP monitoring (ABPM) in patients with resistant hypertension (RH). Thirty-two patients (aged 53 ± 6 years) with RH (4 to 6 antihypertensive drugs) were randomly assigned to HEx (n = 16) or control (n = 16) groups. Antihypertensive therapy remained unchanged during the protocol. The HEx group participated in 36 sessions (60 minutes) in a heated pool (32C [89.6°F]) for 12 weeks (training), followed by 12 weeks of cessation of training. The control group was evaluated during the same period and instructed to maintain their habitual activities.
HEx and control groups had similar BP levels at baseline. HEx training reduced the 24-hour systolic (-19.5 ± 4.6 vs 3.0 ± 0.7 mm Hg, P = 0.001) and diastolic BP (-11.1 ± 2.4 vs 2.06 ± 0.9 mm Hg, P = 0.001) at week 12, compared with the control group. After 12 weeks of training cessation (week 24), 24-hour BP remained significantly lower in the HEx group than in the control group (-9.6 ± 3.8 vs 6.3 ± 3.5 mm Hg, P = 0.01 and -7.5±2.2 vs 2.2 ± 1.0 mm Hg, P = 0.009, for systolic and diastolic BP, respectively), although these differences were attenuated.
BP remained lower after cessation of 12-week training among patients with RH who underwent HEx compared with the controls. The carryover effects of HEx on BP may help to overcome the challenging problem of exercise compliance in long-term follow-up.
水加热运动（HEx）可显著降低血压（BP），但尚不清楚停止 HEx 后其对 BP 的影响是否持续。
我们分析了停止 HEx 对难治性高血压（RH）患者 24 小时动态血压监测（ABPM）的影响。32 例 RH 患者（年龄 53 ± 6 岁，服用 4-6 种降压药）随机分为 HEx 组（n = 16）和对照组（n = 16）。试验期间，两组患者的降压治疗均未改变。HEx 组患者参加 36 次（每次 60 分钟）加热池（32°C[89.6°F]）训练，持续 12 周，随后停止训练 12 周。对照组患者在同一时期接受评估，并指导其保持日常活动。
HEx 组和对照组患者基线 BP 水平相似。HEx 训练可使 24 小时收缩压（-19.5 ± 4.6 比 3.0 ± 0.7mmHg，P = 0.001）和舒张压（-11.1 ± 2.4 比 2.06 ± 0.9mmHg，P = 0.001）在第 12 周时显著降低，与对照组相比。停止训练 12 周（第 24 周）后，HEx 组 24 小时 BP 仍明显低于对照组（-9.6 ± 3.8 比 6.3 ± 3.5mmHg，P = 0.01 和-7.5±2.2 比 2.2 ± 1.0mmHg，P = 0.009，收缩压和舒张压），尽管这些差异有所减弱。
与对照组相比，接受 HEx 的 RH 患者停止 12 周训练后 BP 仍较低。HEx 对 BP 的持续作用可能有助于克服长期随访中运动依从性这一难题。
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