Ramos-Barrera Guadalupe Elizabeth, DeLucia Claire M, Bailey E Fiona
Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona.
J Appl Physiol (1985). 2020 Sep 1;129(3):449-458. doi: 10.1152/japplphysiol.00024.2020. Epub 2020 Jul 30.
Previous work has shown lowered casual blood pressure after just 6 wk of inspiratory muscle strength training (IMST), suggesting IMST as a potential therapeutic in the prevention/treatment of hypertension. In this study, we assessed the effects of IMST on cardiovascular parameters in older, overweight adults diagnosed with moderate and severe obstructive sleep apnea (OSA). Subjects were randomly assigned to one of two interventions ) high-intensity IMST ( = 15, 75% maximal inspiratory pressure), or ) a control intervention ( = 10, 15% maximum inspiratory pressure). Subjects in both groups trained at home completing 30 training breaths/day, 5 days/wk for 6 wk. Pre- and posttraining measures included maximal inspiratory pressure, casual and ambulatory blood pressures, spontaneous cardiac baroreflex sensitivity, and muscle sympathetic nerve activity. Men and women in the high-intensity IMST group exhibited reductions in casual systolic (SBP), diastolic (DBP), and mean arterial blood pressures (MAP) [SBP: -8.82 ± 4.98 mmHg; DBP: -4.69 ± 2.81 mmHg; and MAP: -6.06 ± 1.03 mmHg; < 0.002] and nighttime SBP (pre: -12.00 ± 8.20 mmHg; < 0.01). Muscle sympathetic nerve activities also were lower (-6.97 ± 2.29 bursts/min; = 0.01 and -9.55 ± 2.42 bursts/100 heartbeats; = 0.002) by . Conversely, subjects allocated to the control group showed no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward higher overnight blood pressures. A short course of high-intensity IMST may offer significant respiratory and cardiovascular benefits for older, overweight adults with OSA. For Clinical Trial Registration, see https://www.clinicaltrials.gov (Identifier: NCT02709941). Older, obese adults with moderate-severe obstructive sleep apnea who perform 5 min/day high-intensity inspiratory muscle strength training (IMST) exhibit lowered casual and nighttime systolic blood pressure and sympathetic nervous outflow. In contrast, adults assigned to a control (low-intensity) intervention exhibit no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward increased overnight blood pressure. Remarkably, adherence to IMST even among sleep-deprived and exercise-intolerant adults is high (96%).
先前的研究表明，仅进行6周的吸气肌力量训练（IMST）后，日常血压就会降低，这表明IMST可能是预防/治疗高血压的一种潜在疗法。在本研究中，我们评估了IMST对诊断为中度和重度阻塞性睡眠呼吸暂停（OSA）的老年超重成年人心血管参数的影响。受试者被随机分配到两种干预措施之一：高强度IMST组（n = 15，最大吸气压力的75%），或对照组（n = 10，最大吸气压力的15%）。两组受试者均在家中训练，每天完成30次训练呼吸，每周训练5天，共训练6周。训练前后的测量指标包括最大吸气压力、日常和动态血压、自发性心脏压力反射敏感性以及肌肉交感神经活动。高强度IMST组的男性和女性日常收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）均有所降低[SBP：-8.82±4.98 mmHg；DBP：-4.69±2.81 mmHg；MAP：-6.06±1.03 mmHg；P<0.002]，夜间SBP也降低（训练前：-12.00±8.20 mmHg；P<0.01）。肌肉交感神经活动也降低了（-6.97±2.29次/分钟；P = 0.01和-9.55±2.42次/100次心跳；P = 0.002）。相反，分配到对照组的受试者日常血压和肌肉交感神经活动没有变化，夜间血压有升高的趋势。短期的高强度IMST可能会给患有OSA的老年超重成年人带来显著的呼吸和心血管益处。临床试验注册信息见https://www.clinicaltrials.gov（标识符：NCT02709941）。患有中度至重度阻塞性睡眠呼吸暂停的老年肥胖成年人每天进行5分钟的高强度吸气肌力量训练（IMST），其日常和夜间收缩压以及交感神经输出均会降低。相比之下，分配到对照（低强度）干预组的成年人日常血压和肌肉交感神经活动没有变化，夜间血压有升高的趋势。值得注意的是，即使是睡眠不足和运动不耐受的成年人，对IMST的依从性也很高（96%）。
