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运动训练对动脉血压升高的绝经后女性心率变异性的影响。

Influence of exercise training on heart rate variability in post-menopausal women with elevated arterial blood pressure.

作者信息

Davy K P, Willis W L, Seals D R

机构信息

Department of Kinesiology, University of Colorado, Boulder 80309, USA.

出版信息

Clin Physiol. 1997 Jan;17(1):31-40. doi: 10.1046/j.1365-2281.1997.01010.x.

Abstract

Low heart rate variability (HRV) has been reported to be an independent risk factor for the development of coronary heart disease in women and has recently been identified as a risk factor for cardiac sudden death and all-cause mortality. We have recently demonstrated that endurance-trained post-menopausal women demonstrate higher levels of HRV than sedentary control subjects. The purpose of the present study was to test the hypothesis that 12 weeks of regular aerobic exercise would increase HRV in sedentary post-menopausal women with elevated arterial blood pressure (BP) (i.e. either high normal BP or stage I hypertension). A secondary aim was to test the hypothesis that the increase in HRV with exercise training, if observed, would be associated with an increase in spontaneous cardiac baroreflex sensitivity (SBRS), an important physiological determinant of HRV. To accomplish these aims, we studied eight sedentary post-menopausal women (age = 54.5 +/- 1.3 years) before and after 12 weeks of aerobic exercise training (3.3 +/- 0.3 days per week at 70% +/- 2% of maximal heart rate for 43 +/- 3 min per day). Maximal oxygen uptake and body weight did not change (P > 0.05) with training, but percentage fat (35.5 +/- 2.6% vs. 34.5 +/- 2.3%, P < 0.05) decreased and treadmill time to exhaustion increased (9.8 +/- 0.5 vs. 11.3 +/- 0.5 min, P < 0.05). Supine resting levels of heart rate, RR interval and the standard deviation of the RR interval (time domain measure of HRV) were unchanged (all P > 0.05) from baseline levels after 12 weeks of aerobic training. Similarly, the high-frequency, low-frequency and total power of HRV (frequency domain measures) were also unchanged from baseline (all P > 0.05). SBRS was also not different before and after aerobic exercise training (10 +/- 2 vs. 13 +/- 3 ms mmHg-1 respectively, P > 0.05). In contrast, systolic and diastolic BP were reduced approximately 8 and approximately 5 mmHg with training (both P < 0.05) respectively. These results indicate that 12 weeks of moderate-intensity aerobic exercise training does not increase HRV or SBRS, despite producing a clinically significant reduction in BP at rest in post-menopausal women with elevated BP. Considered together with our previous findings in female master endurance athletes, these findings suggest that more intense and prolonged exercise training may be required to produce increases in HRV and SBRS in sedentary post-menopausal women.

摘要

已有报道称,低心率变异性(HRV)是女性冠心病发生的独立危险因素,最近还被确定为心脏性猝死和全因死亡率的危险因素。我们最近证明,经过耐力训练的绝经后女性的HRV水平高于久坐不动的对照受试者。本研究的目的是检验以下假设:12周的规律有氧运动可使动脉血压(BP)升高(即高正常血压或I期高血压)的久坐绝经后女性的HRV增加。第二个目的是检验以下假设:如果观察到运动训练使HRV增加,这将与自发性心脏压力反射敏感性(SBRS)增加相关,SBRS是HRV的一个重要生理决定因素。为实现这些目标,我们对8名久坐的绝经后女性(年龄=54.5±1.3岁)在进行12周有氧运动训练前后进行了研究(每周3.3±0.3天,以最大心率的70%±2%进行,每天43±3分钟)。最大摄氧量和体重在训练后没有变化(P>0.05),但体脂百分比降低(35.5±2.6%对34.5±2.3%,P<0.05),跑步机力竭时间增加(9.8±0.5对11.3±0.5分钟,P<0.05)。有氧运动训练12周后,仰卧位静息心率、RR间期和RR间期标准差(HRV的时域测量指标)与基线水平相比没有变化(所有P>0.05)。同样,HRV的高频、低频和总功率(频域测量指标)与基线相比也没有变化(所有P>0.05)。有氧运动训练前后SBRS也没有差异(分别为10±2和13±3 ms mmHg-1,P>0.05)。相比之下,收缩压和舒张压在训练后分别降低了约8 mmHg和约5 mmHg(均P<0.05)。这些结果表明,12周的中等强度有氧运动训练不会增加HRV或SBRS,尽管在血压升高的绝经后女性中,该训练使静息血压出现了具有临床意义的降低。结合我们之前在女性中老年耐力运动员中的研究结果,这些发现表明,可能需要更剧烈、更持久的运动训练才能使久坐的绝经后女性的HRV和SBRS增加。

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