Nagoya University Graduate School of Medicine, Nagoya, Japan.
Chutoen General Medical Center, Kakegawa, Japan.
J Clin Nurs. 2022 Jun;31(11-12):1636-1642. doi: 10.1111/jocn.16018. Epub 2021 Aug 29.
The present study investigated whether morning or afternoon activity is more effective at increasing the high-frequency (HF) index, a parasympathetic index, in patients with cardiovascular risk factors.
A decreased HF index, a heart rate variability (HRV) parameter, is a well-established marker of poor cardiovascular prognosis. Because blood pressure and sympathetic tone are higher in the morning, physical activity and exercise in the afternoon has been recommended for patients with cardiovascular diseases. However, there have been no reports concerning the superior effects of afternoon exercise on parasympathetic activity and sleep.
This observational study was a post hoc comparison.
Patients' physical activity was measured for 1 month to determine their habits. Patients' HF index was measured by 24-h Holter electrocardiography. The study enrolled 56 patients. Each patient's morning step count (before lunch) and afternoon step count (between lunch and dinner) were compared. We adhered to the STROBE guidelines in the present study.
Thirty-one patients took more steps in the morning, and 25 patients took more steps in the afternoon. The present study showed that those who took more steps in the afternoon had a significantly higher HF index during the first hour after sleep onset and during sleep than those who took more steps in the morning (p = .003, .047).
The present study showed that those who took more steps in the afternoon had a significantly higher HF index during the first hour after sleep onset and a higher HF index during sleep than those who took more steps in the morning.
Exercise in the afternoon may improve the prognosis in patients with cardiovascular disease by not only preventing excessive blood pressure, afterload, and sympathetic tone but also positively influencing the parasympathetic system and sleep.
本研究旨在探讨心血管危险因素患者中，晨间或午后活动对增加高频（HF）指数（迷走神经指数）的效果是否更为显著。
HF 指数是心率变异性（HRV）的一个参数，其降低是心血管预后不良的一个公认标志物。由于血压和交感神经张力在早晨较高，因此建议心血管疾病患者在下午进行体育活动和锻炼。但是，尚未有关于午后运动对迷走神经活性和睡眠的优越性影响的报告。
这是一项观察性研究的事后比较。
通过 1 个月的时间来测量患者的身体活动情况，以确定他们的习惯。通过 24 小时动态心电图测量患者的 HF 指数。该研究共纳入 56 名患者。比较每位患者的晨间步数（午餐前）和午后步数（午餐和晚餐之间）。本研究遵循 STROBE 指南。
31 名患者晨间步数更多，25 名患者午后步数更多。本研究表明，与晨间相比，午后步数更多的患者在入睡后第一个小时和睡眠期间的 HF 指数明显更高（p =.003，.047）。
本研究表明，与晨间相比，午后步数更多的患者在入睡后第一个小时和睡眠期间的 HF 指数明显更高。
下午的运动不仅可以预防血压、后负荷和交感神经张力过度，而且可以积极影响迷走神经系统和睡眠，从而可能改善心血管疾病患者的预后。
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