Kingwell B A, Jennings G L
Alfred and Baker Medical Unit, Baker Medical Research Institute, Prahran, VIC.
Med J Aust. 1993 Feb 15;158(4):234-8. doi: 10.5694/j.1326-5377.1993.tb121740.x.
Rational use of non-pharmacological therapy for elevated blood pressure requires some knowledge of dose-effect relationships to optimise regimens. We investigated the effects on blood pressure of: one hour of walking at 50% of predetermined maximal work capacity (Wmax); 15 minutes of cycling at 80%-90% of Wmax (high-intensity cycling; HIC)--each performed five days per week; and three 30-minute cycling sessions per week at 65%-70% of Wmax (moderate-intensity cycling; MIC) which we have previously found lowers blood pressure in both normotensive and hypertensive people.
The three exercise interventions and a period of normal sedentary activity were performed for four weeks each, by 14 normotensive volunteers (seven male, seven female) in a randomised 4 x 4 Latin-square design.
MIC produced the greatest blood pressure reduction relative to the period of normal sedentary activity--mean 5/3 mmHg; standard error of the difference (SE-diff) 2/1 mmHg; P < 0.05 in the supine position, and 4/5 mmHg; SE-diff 2/2 mmHg; P < 0.05 standing. Walking induced smaller blood pressure reductions--3/2 mmHg; SE-diff, 2/1 mmHg (P < 0.05 for systolic pressure), and 2/1 mmHg; SE-diff, 2/2 mmHg for the supine and standing positions, respectively. The HIC did not change blood pressure. Heart rate reduction with training was proportional to exercise intensity. Cardiac output, body weight, 24-hour urinary sodium excretion, cholesterol and triglyceride levels did not alter with any of the interventions.
Effects of exercise on blood pressure vary according to the intensity and duration of training bouts. Moderate exercise levels may be optimal, but walking is also effective.
合理使用非药物疗法治疗高血压需要了解一些剂量 - 效应关系,以优化治疗方案。我们研究了以下运动对血压的影响:以预定最大工作能力(Wmax)的50%步行一小时;以Wmax的80% - 90%进行15分钟的骑行(高强度骑行;HIC),每周各进行五天;以及每周进行三次30分钟的骑行,强度为Wmax的65% - 70%(中等强度骑行;MIC),我们之前发现这种运动对正常血压和高血压人群都有降压作用。
14名血压正常的志愿者(7名男性,7名女性)采用随机4×4拉丁方设计,每种运动干预和一段正常久坐活动期各进行四周。
与正常久坐活动期相比,MIC导致的血压下降幅度最大,仰卧位平均下降5/3 mmHg;差异标准误(SE - diff)为2/1 mmHg;P < 0.05,站立位下降4/5 mmHg;SE - diff为2/2 mmHg;P < 0.05。步行引起的血压下降幅度较小,仰卧位收缩压下降3/2 mmHg;SE - diff为2/1 mmHg(P < 0.05),仰卧位和站立位分别下降2/1 mmHg;SE - diff为2/2 mmHg。HIC未改变血压。训练引起的心率下降与运动强度成正比。心输出量、体重、24小时尿钠排泄、胆固醇和甘油三酯水平在任何干预下均未改变。
运动对血压的影响因训练的强度和持续时间而异。中等运动强度可能是最佳的,但步行也有效。