Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil.
Disciplina de Pneumologia do Departamento de Clínica Médica da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil.
Braz J Med Biol Res. 2022 Jul 25;55:e11754. doi: 10.1590/1414-431X2022e11754. eCollection 2022.
It is unclear whether physical activity and cardiorespiratory fitness (CRF) are pathways that link low pulmonary function (LPF) to increased blood pressure (BP). Therefore, we investigated the extent to which CRF and moderate-to-vigorous physical activity (MVPA) mediate the relationship between LPF and high BP in adults. We conducted a cross-sectional study with 1,362 participants that underwent cardiopulmonary exercise testing (CPET), spirometry, and wore an accelerometer to determine physical activity patterns. We performed mediation analyses using structural equations considering peak oxygen uptake (V̇O2) and MVPA as mediators, forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) as independent variables, and systolic and diastolic blood pressure (SBP, DBP) as dependent variables. The probability of alpha error was set at 5%. We found a significant total effect of FVC on SBP and DBP considering V̇O2 as mediator (P<0.01). Indirect effects were also significant, with 42.6% of the total effect of FVC on SBP and 77% on DBP mediated by V̇O2 (P<0.01). We did not observe a direct effect of FVC on SBP and DBP. Considering FEV1 as an independent variable, the total effect on SBP was also significant, as were the indirect effects, mediated by V̇O2 at 14.8% for SBP and 7.6% for DBP (P<0.01). We did not find an indirect effect of FVC or FEV1 considering the MVPA as a mediator. CRF mediates the pathway that links LPF and elevated BP. Therefore, CRF is more sensitive to variations in FVC and FEV1 than MVPA.
目前尚不清楚体力活动和心肺适能（CRF）是否是将肺功能低下（LPF）与血压升高（BP）联系起来的途径。因此，我们研究了 CRF 和中等到剧烈体力活动（MVPA）在多大程度上介导了 LPF 与成年人高血压之间的关系。我们进行了一项横断面研究，共纳入 1362 名参与者，他们接受了心肺运动测试（CPET）、肺量测定和佩戴加速度计以确定体力活动模式。我们使用结构方程进行中介分析，考虑峰值摄氧量（V̇O2）和 MVPA 作为中介，用力肺活量（FVC）和第一秒用力呼气量（FEV1）作为自变量，收缩压和舒张压（SBP、DBP）作为因变量。α 错误的概率设定为 5%。我们发现，考虑到 V̇O2 作为中介，FVC 对 SBP 和 DBP 的总效应具有统计学意义（P<0.01）。间接效应也具有统计学意义，FVC 对 SBP 和 DBP 的总效应中，有 42.6%和 77%分别通过 V̇O2 介导（P<0.01）。我们没有观察到 FVC 对 SBP 和 DBP 的直接效应。考虑到 FEV1 作为自变量，对 SBP 的总效应也具有统计学意义，V̇O2 介导的间接效应分别为 14.8%和 7.6%（P<0.01）。我们没有发现 FVC 或 FEV1 通过 MVPA 作为中介的间接效应。CRF 介导了 LPF 与升高的 BP 之间的联系途径。因此，CRF 比 MVPA 对 FVC 和 FEV1 的变化更为敏感。
