From the Division of Behavioral Medicine, Department of Psychiatry (Sloan, Lauriola, McIntyre), Division of Consultation-Liaison Psychiatry, Department of Psychiatry (Shapiro), Department of Biostatistics, Mailman School of Public Health (Pavlicova), Columbia University Irving Medical Center; and Division of Mental Health Data Science (Choi, Choo, Scodes) and Behavioral and Psychosomatic Medicine, New York State Psychiatric Institute (Sloan), New York, New York.
Psychosom Med. 2021;83(2):125-137. doi: 10.1097/PSY.0000000000000896.
Elevated cardiovascular reactivity to, and reduced recovery from, challenging events may increase the risk of cardiovascular disease, and exercise training may reduce this reactivity. However, in a randomized controlled trial of aerobic versus strength training in sedentary, healthy young adults, we found no training group differences in reactivity or recovery. Because strength training also may have a reactivity-reducing effect, we conducted a secondary analysis of data from another trial, this time with a wait-list control condition.
One hundred nineteen healthy, young, sedentary adults were randomized to a 12-week aerobic training program or wait-list control. Before (T1) and after (T2) training and after 4 weeks of sedentary deconditioning (T3), we measured heart rate (HR), heart rate variability, and blood pressure at rest and in response to and recovery from psychological and orthostatic challenge. Data were analyzed using a group (aerobic versus wait-list) by session (T1, T2, and deconditioning) and by period (baseline, psychological challenge, recovery, standing) three-way analysis of variance with prespecified contrasts.
Aerobic capacity significantly increased at T2 and decreased at T3 only in the aerobic training group. The groups did not differ on HR, heart rate variability, or blood pressure reactivity to or recovery from challenge. Without baseline adjustment, there were no significant treatment differences in response to challenges. With baseline adjustment, there were significant treatment by session effects for HR (Cohen d = 0.54, p = .002), systolic blood pressure (d = 0.44, p = .014), diastolic blood pressure (d = 0.74, p = .002), and root mean squared successive difference (d = 0.48, p = .006) reactivity from T1 to T2 only for orthostatic challenge: at T2, reactivity in the aerobic group was nonsignificantly reduced, compared with T1. In the wait-list group, reactivity significantly increased after T1.
This study raises further doubt about attenuation of cardiovascular reactivity or enhancement of recovery as a cardioprotective mechanism of aerobic exercise training.Clinical Trial Registration:ClinicalTrials.gov Unique identifier: NCT01335737.
对挑战性事件的心血管反应升高和恢复能力降低可能会增加心血管疾病的风险，而运动训练可能会降低这种反应。然而，在一项针对久坐、健康的年轻成年人的有氧运动与力量训练的随机对照试验中，我们没有发现训练组在反应性或恢复性方面的差异。由于力量训练也可能具有降低反应性的作用，我们对另一项试验的数据进行了二次分析，这次采用了候补名单对照条件。
119 名健康、年轻、久坐的成年人被随机分配到 12 周的有氧运动训练计划或候补名单对照组。在训练前（T1）和后（T2）以及 4 周的久坐脱训后（T3），我们测量了心率（HR）、心率变异性和血压在休息时以及对心理和直立挑战的反应和恢复时的变化。数据使用组（有氧运动与候补名单）与会议（T1、T2 和脱训）和期间（基线、心理挑战、恢复、站立）的三向方差分析进行分析，并进行了预设对比。
只有在有氧运动训练组中，T2 时有氧运动能力显著增加，而 T3 时显著下降。两组在心率、心率变异性或血压对挑战的反应或恢复方面没有差异。未经基线调整，对挑战的反应没有显著的治疗差异。经过基线调整，对于 HR（Cohen d = 0.54，p =.002）、收缩压（d = 0.44，p =.014）、舒张压（d = 0.74，p =.002）和均方根连续差值（d = 0.48，p =.006），有显著的治疗与会议效应，仅在直立挑战时从 T1 到 T2 才有反应：在 T2 时，与 T1 相比，有氧运动组的反应性显著降低。在候补名单组中，T1 后反应性显著增加。
这项研究进一步怀疑有氧运动训练作为一种心脏保护机制，是否能降低心血管反应性或增强恢复能力。
ClinicalTrials.gov 独特标识符：NCT01335737。
