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最大运动试验后血压下降能否预测有氧训练对治疗的高血压男性血压降低的效果?

Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men?

机构信息

Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.

Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA.

出版信息

J Hum Hypertens. 2023 Dec;37(12):1070-1075. doi: 10.1038/s41371-023-00853-7. Epub 2023 Aug 16.

Abstract

The acute decrease in blood pressure (BP) observed after a session of exercise (called post-exercise hypotension) has been proposed as a tool to predict the chronic reduction in BP induced by aerobic training. Therefore, this study investigated whether post-exercise hypotension observed after a maximal exercise test is associated to the BP-lowering effect of aerobic training in treated hypertensives. Thirty hypertensive men (50 ± 8 years) who were under consistent anti-hypertensive treatment underwent a maximal exercise test (15 watts/min until exhaustion), and post-exercise hypotension was determined by the difference between BP measured before and at 30 min after the test. Subsequently, the patients underwent 10 weeks of aerobic training (3 times/week, 45 min/session at moderate intensity), and the BP-lowering effect of training was assessed by the difference in BP measured before and after the training period. Pearson correlations were employed to evaluate the associations. Post-maximal exercise test hypotension was observed for systolic and mean BPs (-8 ± 6 and -2 ± 4 mmHg, all P < 0.05). Aerobic training reduced clinic systolic/diastolic BPs (-5 ± 6/-2 ± 3 mmHg, both P < 0.05) as well as awake and 24 h mean BPs (-2 ± 6 and -2 ± 5 mmHg, all P < 0.05). No significant correlation was detected between post-exercise hypotension and the BP-lowering effect of training either for clinic or ambulatory BPs (r values ranging from 0.00 to 0.32, all p > 0.05). Post-exercise hypotension assessed 30 min after a maximal exercise test cannot be used to predict the BP-lowering effect of aerobic training in treated hypertensive men.

摘要

运动后血压(BP)的急性下降(称为运动后低血压)已被提出作为预测有氧运动训练引起的慢性血压降低的工具。因此,本研究调查了在接受治疗的高血压患者中,最大运动试验后观察到的运动后低血压是否与有氧运动训练的降压效果有关。30 名高血压男性(50±8 岁)在持续抗高血压治疗下进行了最大运动试验(15 瓦/分钟直至力竭),并通过测试前和测试后 30 分钟之间的 BP 差值来确定运动后低血压。随后,患者接受了 10 周的有氧运动训练(每周 3 次,中等强度 45 分钟/次),并通过训练前后 BP 的差值评估训练的降压效果。采用 Pearson 相关分析评估相关性。最大运动后试验后收缩压和平均血压均出现低血压(-8±6 和-2±4mmHg,均 P<0.05)。有氧运动训练降低了诊室收缩压/舒张压(-5±6/-2±3mmHg,均 P<0.05)以及清醒和 24 小时平均血压(-2±6 和-2±5mmHg,均 P<0.05)。运动后低血压与训练的降压效果之间,无论是诊室血压还是动态血压,均未检测到显著相关性(r 值范围为 0.00 至 0.32,均 p>0.05)。最大运动试验后 30 分钟评估的运动后低血压不能用于预测接受治疗的高血压男性有氧运动训练的降压效果。

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