School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China (mainland).
Clin Exp Hypertens. 2021 Nov 17;43(8):691-698. doi: 10.1080/10641963.2021.1945074. Epub 2021 Jul 5.
The studies regarding the effects of exercise duration on blood pressure have reported inconsistent and conflicting results. Nitric oxide (NO) is a well-known vasodilator released by endothelial cells, and endothelial microparticles (EMPs) are membranous vesicles released into the circulation from activated or apoptotic endothelial cells, both of whose level can reflect the endothelial function. But few studies have been done to explore the effect of exercise duration on blood pressure and endothelial function, especially, the EMPs response to exercise in young male patients with hypertension. This study aimed to investigate the blood pressure response during moderate-intensity exercise performed in different durations and the acute effects on post-exercise hypotension and endothelial function in hypertensive patients.
Eighteen young male hypertensive patients who did not take antihypertensive drugs were recruited in this study. They randomly performed twice exercises on a cycle ergometer at a moderate intensity of 40%-50% of their HR reserve; one was 20 min (E20 session), the other one was 40 min (E40 session); there was 1-week break between the two exercises. Blood pressure was monitored by the YUWELL blood pressure monitor at rest, every 5 min during exercise, and 3 and 6 min post-exercise. The level of NO (nitrate/nitrite reduction) and EMPs (flow cytometry) in plasma were detected before and immediately following exercise. CD31/CD42b events were classified as EMPs and events per microliter plasma were calculated. This study was approved by the Beijing Sport University Institutional Review Board (protocol number 2019087 H).
Mean age of patients was 34.8 ± 3.5 yrs, and BMI was 27.6 ± 2.7 kg/m. Systolic blood pressure (SBP) in the two sessions increased significantly during exercise. The SBP in the E20 session increased by 37 mmHg ( < .01) at 5 min during exercise and remained stable afterward. In the E40 session, the SBP increased by 35 mmHg ( < .01) at 5 min during exercise and was stable at 5 through 25 min, decreased by 8 mmHg at 25 through 35 min during exercise, and then stabilized ( < .01). There was no obvious change of diastolic blood pressure (DBP) in the two sessions during exercise. In the E20 session, SBP at 6 min following exercise was no different from the rest; in the E40 session, SBP at 6 min following exercise was 14 mmHg lower than at the rest ( < .01). DBP in the E20 session was the same as rest at 3 min following exercise and decreased by 4 mmHg at 6 min following exercise compared with the rest ( < .05), while DBP in the E40 session decreased by 3 mmHg at 3 min following exercise compared with the rest ( < .05). The plasma NO levels of E20 and E40 increased significantly following exercise ( < .01 for both). There was no difference in plasma NO level between the two sessions pre- and post-exercise, but the increased magnitude of NO level in E40 was greater than that in E20 (24.47% vs. 9.24%, < .01). The plasma EMPs level of E20 and E40 decreased significantly following exercise ( < .01 for both). There was no difference in plasma EMPs level between the two sessions pre- and post-exercise, but the decreased magnitude of EMPs level in E40 was greater than that in E20 (15.66% vs. 8.00%, < .01).
There is no exaggerated blood pressure response to 20-min and 40-min acute moderate-intensity exercise in young hypertensive men with no antihypertensive drugs. Both 20-min and 40-min acute moderate exercise can reduce the rest blood pressure, and improve endothelial function by increasing NO and decreasing EMPs in young male patients with hypertension, and the effects of 40-min exercise on lowering SBP and improving endothelial function are better than that of 20-min.
关于运动持续时间对血压影响的研究报告结果不一致且相互矛盾。一氧化氮(NO)是一种众所周知的内皮细胞释放的血管扩张剂,内皮细胞微粒(EMP)是从激活或凋亡的内皮细胞释放到循环中的膜性囊泡,其水平均能反映内皮功能。但很少有研究探讨运动持续时间对血压和内皮功能的影响,尤其是高血压青年男性患者运动后低血压和内皮细胞微粒的反应。本研究旨在探讨不同持续时间的中等强度运动对血压的反应以及对高血压患者运动后低血压和内皮功能的急性影响。
本研究纳入了 18 名未服用抗高血压药物的年轻男性高血压患者。他们在自行车功量计上以 40%-50%的 HR 储备进行两次中等强度的运动,一次持续 20 分钟(E20 运动),一次持续 40 分钟(E40 运动);两次运动之间休息一周。在休息时、运动期间每 5 分钟以及运动后 3 分钟和 6 分钟使用 YUWELL 血压监测仪监测血压。运动前后检测血浆中 NO(硝酸盐/亚硝酸盐还原)和 EMPs(流式细胞术)的水平。北京体育大学机构审查委员会(编号 2019087)批准了本研究。
患者的平均年龄为 34.8 ± 3.5 岁,BMI 为 27.6 ± 2.7 kg/m2。在两次运动中,收缩压(SBP)在运动期间显著升高。E20 运动中,SBP 在运动的第 5 分钟增加了 37mmHg(<0.01),之后保持稳定。在 E40 运动中,SBP 在运动的第 5 分钟增加了 35mmHg(<0.01),并在 5 至 25 分钟之间保持稳定,在 25 至 35 分钟之间下降了 8mmHg,之后稳定(<0.01)。两次运动中,舒张压(DBP)在运动期间没有明显变化。在 E20 运动中,运动后 6 分钟的 SBP 与休息时相同;在 E40 运动中,运动后 6 分钟的 SBP 比休息时低 14mmHg(<0.01)。E20 运动中,DBP 在运动后 3 分钟与休息时相同,与休息时相比,运动后 6 分钟时下降了 4mmHg(<0.05),而 E40 运动中,DBP 在运动后 3 分钟时下降了 3mmHg(<0.05)。E20 和 E40 运动后血浆 NO 水平显著升高(两者均<0.01)。两次运动前后,血浆 NO 水平无差异,但 E40 运动后 NO 水平的增加幅度大于 E20(24.47%比 9.24%,<0.01)。E20 和 E40 运动后,血浆 EMPs 水平显著降低(两者均<0.01)。两次运动前后,血浆 EMPs 水平无差异,但 E40 运动后 EMPs 水平的降低幅度大于 E20(15.66%比 8.00%,<0.01)。
在没有服用抗高血压药物的年轻高血压男性中,20 分钟和 40 分钟的急性中等强度运动不会引起血压过度升高。20 分钟和 40 分钟的急性中等强度运动均可降低静息血压,并通过增加 NO 和减少 EMPs 改善高血压男性患者的内皮功能,40 分钟运动对降低 SBP 和改善内皮功能的效果优于 20 分钟运动。