School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre.
Centro Universitário Metodista - IPA, Porto Alegre, Rio Grande do Sul, Brazil.
J Hypertens. 2020 Dec;38(12):2501-2509. doi: 10.1097/HJH.0000000000002581.
The current randomized controlled trial tested the hypothesis that both aerobic training and dynamic resistance training will improve inflammation, endothelial function and 24-h ambulatory blood pressure (ABP) in middle-aged adults with hypertension, but aerobic training would be more effective.
Forty-two hypertensive patients on at least one antihypertensive medication (19 men/23 women; 30-59 years of age) were randomly assigned to 12 weeks of supervised aerobic training (n = 15), resistance training (n = 15) or a nonexercise control (n = 12) group. Inflammation, endothelial function, 24-h ABP and related measures were evaluated at pre and postintervention.
We found that aerobic training and resistance training were well tolerated. Both aerobic training and resistance training reduced daytime systolic ABP (-7.2 ± 7.9 and -4.4 ± 5.8 mmHg; P < 0.05) and 24-h systolic ABP (-5.6 ± 6.2 and -3.2 ± 6.4 mmHg; P < 0.05). aerobic training and resistance training both improved brachial artery flow-mediated dilation by 1.7 ± 2.8 and 1.4 ± 2.6%, respectively (7.59 ± 3.36 vs. 9.26 ± 2.93 and 7.24 ± 3.18 vs. 8.58 ± 2.37; pre vs. post P < 0.05). However, only aerobic training decreased markers of inflammation (C-reactive protein, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1 and lectin-like oxidized LDL receptor-1) and endothelin-1 and increased nitrite and nitrate levels (P < 0.05).
Healthcare providers should continue to emphasize aerobic training for hypertension management given the established role of nitric oxide, endothelin-1 and chronic low-level inflammation in the pathogenesis of cardiovascular disease. However, our study demonstrates that resistance training should also be encouraged for middle-aged hypertensive patients. Our results also suggest that even if patients are on antihypertensive medications, regular aerobic training and resistance training are beneficial for blood pressure control and cardiovascular disease risk reduction.
本随机对照试验旨在检验以下假设，即有氧运动和动力抗阻训练均可改善高血压中年患者的炎症、内皮功能和 24 小时动态血压，但有氧运动的效果更为显著。
42 例服用至少一种降压药物的高血压患者（男 19 例，女 23 例；年龄 30-59 岁）被随机分为 12 周的监督有氧运动组（n=15）、抗阻训练组（n=15）或非运动对照组（n=12）。干预前后评估炎症、内皮功能、24 小时动态血压及相关指标。
我们发现有氧运动和抗阻训练均耐受良好。有氧运动和抗阻训练均降低日间收缩压（-7.2±7.9 和-4.4±5.8mmHg；P<0.05）和 24 小时收缩压（-5.6±6.2 和-3.2±6.4mmHg；P<0.05）。有氧运动和抗阻训练均可使肱动脉血流介导的扩张分别增加 1.7±2.8%和 1.4±2.6%（7.59±3.36 比 9.26±2.93 和 7.24±3.18 比 8.58±2.37；P<0.05）。然而，只有有氧运动训练降低了炎症标志物（C 反应蛋白、单核细胞趋化蛋白-1、血管细胞黏附分子-1 和凝集素样氧化 LDL 受体-1）和内皮素-1 水平，增加了硝酸盐和亚硝酸盐水平（P<0.05）。
鉴于一氧化氮、内皮素-1 和慢性低度炎症在心血管疾病发病机制中的作用已得到确立，医护人员应继续强调有氧运动在高血压管理中的作用。然而，我们的研究表明，抗阻训练也应鼓励中年高血压患者进行。我们的研究结果还表明，即使患者正在服用降压药物，定期进行有氧运动和抗阻训练也有益于控制血压和降低心血管疾病风险。
