Müller Cédric, Hauser Christoph, Carrard Justin, Gugleta Konstantin, Hinrichs Timo, Schmidt-Trucksäss Arno, Hanssen Henner, Streese Lukas
Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland.
Department of Ophthalmology, University Hospital Basel, Basel, Switzerland.
Microvasc Res. 2024 Jan;151:104616. doi: 10.1016/j.mvr.2023.104616. Epub 2023 Oct 27.
Arterial hypertension is a global healthcare burden that affects macrovascular and microvascular structure and function and can promote vascular end-organ damage. This study aimed 1) to evaluate differences in microvascular health between normotensive individuals and patients with arterial hypertension and 2) to assess the effects of short-term high-intensity interval training (HIIT) on microvascular health in the subgroup with arterial hypertension as add-on treatment to antihypertensive medication.
In the cross-sectional part, central retinal arteriolar (CRAE) and venular diameter equivalent (CRVE), arteriolar-to-venular diameter ratio (AVR), and retinal oxygen saturation (O-saturation) were investigated in 19 normotensive healthy controls (mean age 56 ± 7 years) and 41 patients with arterial hypertension (mean age 59 ± 7 years). In the subsequent randomized controlled trial (RCT), patients with arterial hypertension were randomized to an intervention group (HIIT 3×/week) or a control group that received standard physical activity recommendations after baseline assessment. Assessments of retinal vessel biomarkers and patients` characteristics were repeated after the intervention period of 8 weeks.
In the cross-sectional part, individuals with normal blood pressure (BP) showed lower body mass index (BMI), body fat, 24 h systolic and diastolic BP, higher peak oxygen uptake, wider CRAE (174 ± 17 μm vs. 161 ± 17 μm, p = 0.009), and higher AVR (0.84 ± 0.05 vs. 0.79 ± 0.05, p = 0.003) compared to patients with hypertension. In the RCT, patients with arterial hypertension showed reduced BMI and fasting glucose levels after HIIT and control condition. In addition, the intervention group reduced body fat percentage (27.0 ± 5.5 vs. 25.8 ± 6.1, p = 0.023) and increased peak oxygen uptake (33.3 ± 5.7 vs. 36.7 ± 5.1, p < 0.001). No changes in BP were found in either group. The intervention group showed narrower CRVE (β -4.8 [95 % CI, -8.85, -0.81] p = 0.020) and higher AVR (0.03 [0.01, 0.04] p < 0.001) after eight weeks of HIIT compared to the control group. No statistically significant changes in retinal O-saturation were found in either group.
Short-term HIIT proved to be an effective treatment to ameliorate hypertension-induced retinal microvascular abnormalities in patients with hypertension. Retinal vessel diameters may prove to be a sensitive biomarker to quantify treatment efficacy at the microvascular level, at the earliest possible stage in patients with hypertension.
动脉高血压是一种全球性的健康负担，会影响大血管和微血管的结构与功能，并可导致血管终末器官损伤。本研究旨在：1）评估血压正常个体与动脉高血压患者之间微血管健康的差异；2）评估短期高强度间歇训练（HIIT）作为抗高血压药物的附加治疗对动脉高血压亚组患者微血管健康的影响。
在横断面研究部分，对19名血压正常的健康对照者（平均年龄56±7岁）和41名动脉高血压患者（平均年龄59±7岁）进行了视网膜中央动脉等效直径（CRAE）、静脉等效直径（CRVE）、动静脉直径比（AVR）以及视网膜氧饱和度（O-饱和度）的检测。在随后的随机对照试验（RCT）中，动脉高血压患者被随机分为干预组（每周进行3次HIIT）或对照组，对照组在基线评估后接受标准体育活动建议。在8周的干预期结束后，重复进行视网膜血管生物标志物和患者特征的评估。
在横断面研究中，血压正常的个体与高血压患者相比，体重指数（BMI）、体脂、24小时收缩压和舒张压更低，峰值摄氧量更高，CRAE更宽（174±17μm对161±17μm，p = 0.009），AVR更高（0.84±0.05对0.79±0.05，p = 0.003）。在RCT中，动脉高血压患者在HIIT和对照条件下BMI和空腹血糖水平均降低。此外，干预组的体脂百分比降低（27.0±5.5对25.8±6.1，p = 0.023），峰值摄氧量增加（33.3±5.7对36.7±5.1，p < 0.001）。两组血压均无变化。与对照组相比，干预组在进行8周HIIT后CRVE变窄（β -4.8 [95%CI，-8.85，-0.81] p = 0.020），AVR升高（0.03 [0.01，0.04] p < 0.001）。两组视网膜O-饱和度均未发现有统计学意义的变化。
短期HIIT被证明是改善高血压患者高血压诱导的视网膜微血管异常的有效治疗方法。视网膜血管直径可能是在高血压患者最早阶段量化微血管水平治疗效果的敏感生物标志物。
