School of Human and Life Sciences, Canterbury Christ Church University, Kent.
Department of Cardiovascular Medicine, Oxford Clinical Cardiovascular Research Facility, University of Oxford, Oxford.
J Hypertens. 2019 Apr;37(4):827-836. doi: 10.1097/HJH.0000000000001922.
Hypertension remains the leading modifiable risk factor for cardiovascular disease. Isometric exercise training (IET) has been shown to be a useful nonpharmacological intervention for reducing resting blood pressure (BP). This study aimed to measure alterations in office BP, ambulatory BP, cardiac autonomic modulation and inflammatory and vascular biomarkers following a programme of IET in unmedicated hypertensive patients.
Twenty-four unmedicated stage 1 hypertensive patients (age 43.8 ± 7.3 years; height, 178.1 ± 7 cm; weight 89.7 ± 12.8 kg) were randomly assigned in a cross-over study design, to 4-weeks of home-based IET and control period, separated by a 3-week washout period. Office and ambulatory BP, cardiac autonomic modulation, and inflammatory and vascular biomarkers were recorded pre and post-IET and control periods.
Clinic and 24-h ambulatory BP significantly reduced following IET by 12.4/6.2 and 11.8/5.6 mmHg in SBP/DBP, respectively (P < 0.001 for both), compared with the control. The BP adaptations were associated with a significant (P = 0.018) reduction in the average real variability of 24-h ambulatory BP following IET, compared with control. Cardiac autonomic modulation improved by 11% (P < 0.001), baroreceptor reflex sensitivity improved by 47% (P < 0.001), and IL-6 and asymmetric dimethylarginine reduced by 10% (P = 0.022) and 19% (P = 0.023), respectively, which differed significantly to the control period.
This is the first evidence of durable BP reduction and wider cardiovascular disease risk benefits of IET in a relevant patient population. Our findings support the role of IET as a safe and viable therapeutic and preventive intervention in the treatment of hypertension.
高血压仍然是心血管疾病的主要可改变风险因素。等长运动训练（IET）已被证明是一种有用的非药物干预手段，可降低静息血压（BP）。本研究旨在测量未经药物治疗的高血压患者进行 IET 计划后，办公室血压、动态血压、心脏自主调节以及炎症和血管生物标志物的变化。
24 名未经药物治疗的 1 期高血压患者（年龄 43.8±7.3 岁；身高 178.1±7cm；体重 89.7±12.8kg）按照交叉设计随机分配到家庭 IET 和对照组，间隔 3 周洗脱期。在 IET 和对照组之前和之后记录办公室和动态血压、心脏自主调节以及炎症和血管生物标志物。
IET 后，诊室和 24 小时动态血压分别显著降低 12.4/6.2 和 11.8/5.6mmHg（SBP/DBP，均 P<0.001），与对照组相比。BP 适应与 24 小时动态血压平均真实变异性显著降低（P=0.018）相关，与对照组相比，IET 后 IET 降低了 11%（P<0.001），压力感受器反射敏感性提高了 47%（P<0.001），IL-6 和不对称二甲基精氨酸分别降低了 10%（P=0.022）和 19%（P=0.023）。
这是 IET 在相关患者人群中具有持久降压作用和更广泛的心血管疾病风险益处的首次证据。我们的研究结果支持 IET 作为一种安全可行的治疗和预防高血压的治疗干预措施的作用。
