Nephrology Department, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Department of Internal Medicine "C", "D" and "E", Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Clin Hypertens (Greenwich). 2019 Aug;21(8):1171-1179. doi: 10.1111/jch.13624. Epub 2019 Jul 8.
Albuminuria is a known marker for endothelial dysfunction and cardiovascular events, even below the threshold of moderately increased albuminuria (MIA). Post-exercise increased albuminuria may precede the appearance of rest MIA, enabling detection of early injury. Modifying lifestyle for a population at risk for MIA is therefore of interest. Our aim was to evaluate post-exercise albuminuria in hypertensive compared with normotensive individuals and to analyze the effect of an active lifestyle on rest and post-exercise albumin excretion. The study cohort consisted of 3931 adults who participated in a health-screening program. Albuminuria was measured as urine albumin-to-creatinine ratio (ACR). Lifestyle was divided into three groups: non-active, less-active, and active according to regular sport activity, categorized as follows: none, <2.5 and ≥2.5 hours per week. Mean age was 47.7 years, and 31.2% (n = 1228) were diagnosed with hypertension. Both rest and post-exercise ACR were higher in hypertensive compared to normotensive participants. Rest ACR was higher in non-active compared to less-active and active hypertensive participants. Hypertensive participants with an active lifestyle had significantly lower post-exercise and delta ACR compared to less-active and non-active hypertensive participants. Parameters related to delta ACR in hypertensive participants were increased age, BMI, and diabetes, while active lifestyle and fitness (measured as METS achieved by a stress test) were protective. In conclusion, there is an association between hypertension and increased albumin excretion post-exercise, which can be attenuated with an active lifestyle.
尿白蛋白排泄量是内皮功能障碍和心血管事件的已知标志物,甚至在中度增加尿白蛋白排泄量(MIA)阈值以下也是如此。运动后尿白蛋白排泄量增加可能先于休息时 MIA 的出现,从而能够检测到早期损伤。因此,改变有发生 MIA 风险的人群的生活方式是有意义的。我们的目的是评估高血压患者与血压正常者相比运动后的尿白蛋白排泄量,并分析积极的生活方式对休息时和运动后尿白蛋白排泄量的影响。研究队列由 3931 名参加健康筛查计划的成年人组成。尿白蛋白排泄量通过尿白蛋白/肌酐比值(ACR)来测量。根据定期的体育活动,生活方式分为三组:非活跃、较少活跃和活跃,具体分类如下:无、<2.5 小时/周和≥2.5 小时/周。平均年龄为 47.7 岁,31.2%(n=1228)被诊断为高血压。与血压正常者相比,高血压患者的休息和运动后 ACR 均较高。与较少活跃和活跃的高血压患者相比,非活跃的高血压患者休息时 ACR 更高。与较少活跃和非活跃的高血压患者相比,生活方式积极的高血压患者运动后和 delta ACR 显著降低。与高血压患者 delta ACR 相关的参数为年龄、BMI 和糖尿病增加,而积极的生活方式和体能(通过压力测试测量的 METS 来衡量)具有保护作用。总之,高血压与运动后白蛋白排泄量增加有关,而积极的生活方式可以减轻这种关系。