Miura S, Tashiro E, Sakai T, Koga M, Kinoshita A, Sasaguri M, Ideishi M, Ikeda M, Tanaka H, Shindo M
Department of Internal Medicine, School of Medicine, Fukuoka University, Japan.
J Hypertens. 1994 Jul;12(7):815-23.
To determine whether the renal kallikrein-kinin and dopamine systems participate in lowering blood pressure during mild exercise in hypertensives.
After a general clinical observation period of 4 weeks, 27 essential hypertensives were divided into two groups. The exercise group underwent blood lactate threshold exercise, using a cycle ergometer for 60 min three times a week for 10 weeks. The non-exercise group was observed at the outpatient clinic. Blood pressure and humoral parameters were measured at weeks 0, 1, 2, 4 and 10 in both groups.
Blood pressure was measured indirectly with an automatic blood pressure recorder. Twenty-four-hour urinary kallikrein activity (by kininogenase assay), total or free dopamine and total noradrenaline (by high-performance liquid chromatography) were also measured.
In the non-exercise group blood pressure and humoral parameters did not change. In the exercise group the change in resting blood pressure between weeks 0 and 10 was statistically significant. The change in 24-h urinary kallikrein activity of the exercise group was significantly greater than that of the non-exercise group between weeks 0 and 1 and weeks 0 and 2. Moreover, the change in systolic blood pressure (SBP) between weeks 0 and 2 was negatively correlated with the change in urinary kallikrein activity between weeks 0 and 2, the change in total dopamine between weeks 0 and 2 was negatively correlated with the change in diastolic blood pressure in the same period, and the change in SBP between weeks 0 and 10 was positively correlated with the change in total noradrenaline in the same period in the exercise group. Subjects with a relatively high baseline urinary kallikrein activity had a significantly greater change in SBP between weeks 0 and 10 than subjects with a relatively low baseline activity.
The renal kallikrein-kinin and dopamine systems may participate in lowering blood pressure during the first few weeks of exercise training. The subsequent reduction of sympathetic activity may be involved in maintaining the lowered blood pressure. Mild exercise is more effective in reducing blood pressure in hypertensives who have a relatively high basal renal kallikrein-kinin system activity.
确定肾激肽释放酶-激肽系统和多巴胺系统是否参与高血压患者轻度运动时的血压降低过程。
在4周的一般临床观察期后，将27例原发性高血压患者分为两组。运动组进行血乳酸阈运动，使用自行车测力计，每周3次，每次60分钟，共10周。非运动组在门诊进行观察。两组在第0、1、2、4和10周测量血压和体液参数。
使用自动血压记录仪间接测量血压。还测量了24小时尿激肽释放酶活性（通过激肽原酶测定）、总多巴胺或游离多巴胺以及总去甲肾上腺素（通过高效液相色谱法）。
非运动组的血压和体液参数未发生变化。运动组在第0周和第10周之间静息血压的变化具有统计学意义。运动组在第0周和第1周以及第0周和第2周之间24小时尿激肽释放酶活性的变化显著大于非运动组。此外，运动组在第0周和第2周之间收缩压（SBP）的变化与同期尿激肽释放酶活性的变化呈负相关，第0周和第2周之间总多巴胺的变化与同期舒张压的变化呈负相关，第0周和第10周之间SBP的变化与同期总去甲肾上腺素的变化呈正相关。基线尿激肽释放酶活性相对较高的受试者在第0周和第10周之间SBP的变化显著大于基线活性相对较低的受试者。
肾激肽释放酶-激肽系统和多巴胺系统可能在运动训练的最初几周参与血压降低过程。随后交感神经活动的降低可能参与维持血压降低。轻度运动对基础肾激肽释放酶-激肽系统活性相对较高的高血压患者降低血压更有效。
