Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
BMJ Open. 2022 Jun 6;12(6):e058997. doi: 10.1136/bmjopen-2021-058997.
Hypertension is a global healthcare burden that affects the structure and function of the macrocirculation and microcirculation and induces disease-specific end-organ damage. Vascular biomarkers are essential to timely diagnose this end-organ damage to improve cardiovascular (CV) risk stratification and medical decision making. Exercise therapy is an effective means to improve vascular health and reduce overall CV risk. However, it is still not clear whether high-intensity interval training (HIIT) is recommendable for patients with hypertension to reduce blood pressure, increase cardiorespiratory fitness and ameliorate vascular health.
The 'Hypertension and retinal microvascular dysfunction' trial will investigate macrovascular and microvascular impairments in hypertensive patients compared with healthy controls to investigate hypertension-induced end-organ damage by using gold-standard methods as well as newly developed unique retinal microvascular biomarkers. In addition, this trial will investigate the reversibility of retinal end-organ damage by assessing the effects of an 8-week supervised and walking based HIIT on blood pressure, cardiorespiratory fitness as well as macrovascular and microvascular health, compared with a control group following standard physical activity recommendations. Primary outcome will be the arteriolar-to-venular diameter ratio. Secondary outcomes will be arteriolar and venular diameters as well as the flicker-light-induced dilation. Further outcomes will be other retinal microvascular biomarkers, flow-mediated dilation of the brachial artery as well as blood pressure, cardiorespiratory fitness, microalbuminuria, hypertensive retinopathy and classical CV risk markers. Analysis of variance and analysis of covariance will be used to investigate group differences between healthy controls and hypertensive patients and training effects in hypertensive patients, respectively.
The Ethics Committee of Northwestern and Central Switzerland approved this study (EKNZ-2021-00086). All participants will give informed consent.
NCT04763005.
高血压是一种全球性的医疗负担，它会影响大循环和微循环的结构和功能，并导致特定疾病的靶器官损伤。血管生物标志物对于及时诊断这种靶器官损伤以改善心血管（CV）风险分层和医疗决策至关重要。运动疗法是改善血管健康和降低整体 CV 风险的有效手段。然而，高强度间歇训练（HIIT）是否适合高血压患者降低血压、提高心肺适应能力和改善血管健康，目前仍不清楚。
“高血压与视网膜微血管功能障碍”试验将比较高血压患者与健康对照组的大血管和微血管损伤，以使用金标准方法以及新开发的独特视网膜微血管生物标志物来研究高血压引起的靶器官损伤。此外，该试验将通过评估 8 周监督和基于步行的 HIIT 对血压、心肺适应能力以及大血管和微血管健康的影响，与遵循标准体育活动建议的对照组进行比较，来研究视网膜靶器官损伤的可逆性。主要结局将是小动脉-小静脉直径比。次要结局将是小动脉和小静脉直径以及闪烁光诱导的扩张。进一步的结局将是其他视网膜微血管生物标志物、肱动脉血流介导的扩张以及血压、心肺适应能力、微量白蛋白尿、高血压性视网膜病变和经典的 CV 风险标志物。方差分析和协方差分析将分别用于研究健康对照组和高血压患者之间的组间差异以及高血压患者的训练效果。
西北和瑞士中央州伦理委员会批准了这项研究（EKNZ-2021-00086）。所有参与者都将给予知情同意。
NCT04763005。
