健身对运动血压的影响及其与青少年心脏结构的关系。
The influence of fitness on exercise blood pressure and its association with cardiac structure in adolescence.
机构信息
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK.
出版信息
Scand J Med Sci Sports. 2020 Jun;30(6):1033-1039. doi: 10.1111/sms.13645. Epub 2020 Apr 1.
PURPOSE
Exaggerated exercise blood pressure (BP) is associated with altered cardiac structure and increased cardiovascular risk. Fitness modifies these associations, but the effect in healthy adolescents is unknown. We performed an observational study to determine the influence of fitness on post-exercise BP, and on its relationship with cardiac structure in adolescents.
METHODS
4835 adolescents from the Avon Longitudinal Study of Parents and Children, (15.4 (0.3) years, 49% male) completed a submaximal cycle test. Fitness was estimated as physical work capacity 170 adjusted for lean body mass and post-exercise BP measured immediately posttest. Cardiovascular structure and function, including left ventricular (LV) mass (n = 1589), left atrium (LA) size (n = 1466), cardiac output (CO, n = 1610), and total peripheral resistance (TPR, n = 1610) were measured at rest by echocardiography 2.4 (0.4) years later.
RESULTS
Post-exercise systolic BP increased stepwise by fitness tertile (131.2 mm Hg [130.4, 132.1]; 137.3 mm Hg [136.5, 138.0]; 142.3 mm Hg [141.5, 143.1]). Each 5 mm Hg of post-exercise systolic BP was associated with 2.46 g [1.91, 3.01] greater LV mass, 0.02 cm [0.02, 0.03] greater LA size, and 0.25 g/m [0.14, 0.36] greater LV mass index. Adjustment for fitness abolished associations (0.29 g [-0.16, 0.74]; 0.01 cm [-0.001, 0.014] and 0.08 g/m [-0.001, 0.002]). Similar associations between post-exercise systolic BP and each outcome were found between the lowest and highest fitness thirds. CO increased with fitness third (difference 0.06 L/min [-0.05, 0.17]; 0.23 L/min [0.12, 0.34]) while TPR decreased (difference -0.13 mm Hg·min/L [-0.84,0.59]; -1.08 mm Hg·min/L [-0.1.80, 0.35]).
CONCLUSIONS
Post-exercise systolic BP increased with fitness, which modified its association with cardiac structure. Higher CO, but lower TPR suggests a physiologically adapted cardiovascular system with greater fitness, highlighting the importance of fitness in adolescence.
目的
运动后血压（BP）升高与心脏结构改变和心血管风险增加有关。健康状况可以改变这些关联，但在健康青少年中的影响尚不清楚。我们进行了一项观察性研究，以确定健康状况对运动后血压的影响，以及其与青少年心脏结构的关系。
方法
来自阿冯纵向父母和儿童研究（Avon Longitudinal Study of Parents and Children，15.4（0.3）岁，49%为男性）的 4835 名青少年完成了一项次最大循环测试。通过将身体工作能力调整为瘦体重后的 170 来估计体能，运动后即刻测量运动后血压。两年零四个月后，通过超声心动图测量心血管结构和功能，包括左心室（LV）质量（n=1589）、左心房（LA）大小（n=1466）、心输出量（CO，n=1610）和总外周阻力（TPR，n=1610）。
结果
运动后收缩压按体能三分位递增（131.2mmHg[130.4，132.1]；137.3mmHg[136.5，138.0]；142.3mmHg[141.5，143.1]）。每 5mmHg 的运动后收缩压与 2.46g[1.91，3.01]更大的 LV 质量、0.02cm[0.02，0.03]更大的 LA 大小和 0.25g/m[0.14，0.36]更大的 LV 质量指数相关。适应能力的调整消除了相关性（0.29g[-0.16，0.74]；0.01cm[-0.001，0.014]和 0.08g/m[-0.001，0.002]）。在体能最低和最高三分位之间，运动后收缩压与每个结果之间也存在类似的关联。CO 随体能三分位增加（差异 0.06L/min[-0.05，0.17]；0.23L/min[0.12，0.34]），而 TPR 降低（差异-0.13mmHg·min/L[-0.84，0.59]；-1.08mmHg·min/L[-0.1.80，0.35]）。
结论
运动后收缩压随体能的增加而升高，这改变了其与心脏结构的关系。更高的 CO，但更低的 TPR 表明心血管系统具有更高的适应性，这表明在青少年时期，体能很重要。
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