有氧运动对难治性高血压患者动态血压和运动能力的影响

Effects of Endurance Training on Ambulatory Blood Pressure and Exercise Capacity in Refractory Hypertension Patients

目的:旨在探索有氧运动对难治性高血压患者动态血压和运动能力的影响。方法:43名难治性高血压患者随机分为运动组(n=23)和对照组(n=20)。运动组进行为期16周的有氧运动训练,对照组保持日常生活习惯不变。分别于实验前后测定各组受试者的身高、体重、身体质量指数(BMI)、体脂百分比、安静心率、诊室血压(OBP)、24h动态血压(ABP)、动脉顺应性(C1和C2),利用递增负荷运动实验测定最大吸氧量(VO2max)并描记运动过程中的心率曲线、主观疲劳感觉(RPE)曲线和血压曲线。结果:两组受试者基线变量之间均无显著性差异(P>0.05),组间具有可比性。实验后,运动组体重、BMI、体脂百分比、安静心率均显著性下降;各类血压指标中,24h ABP均值中收缩压(SBP)下降了5mmHg(P<0.01)、舒张压(DBP)下降了3mmHg(P<0.01)、日间SBP下降了6mmHg(P<0.01)、日间DBP下降了4mmHg(P<0.01),而夜间ABP及OBP均无显著性变化(P>0.05);动脉顺应性(C1和C2)在实验前后无显著性差异(P>0.05);VO2max显著性升高(P<0.01);递增负荷运动实验中心率曲线、RPE曲线以及血压曲线均发生右移。而对照组各指标在实验前后均无显著性变化(P>0.05)。结论:16周有氧运动可有效降低难治性高血压患者血压水平并提高其运动能力。

Objective：The purpose of this study was to investigate the effects of endurance training on ambulatory blood pressure and exercise capacity in refractory hypertension patients. Methods： Forty-three refractory hypertension patients were randomly divided into exercise group （n = 23 ） and control group （ n = 20）. Subjects of exercise group performed a sixteen-week endurance training prescription and control group maintained their daily life style. Body height, body weight, body mass index （BMI）, percentage of body fat, rest heart rate, office blood pressure （OBP）, 24-hour ambulatory blood pressure （ABP）, arterial compliance （C1 and C2）, maximal oxygen intake （VO2max） by graded exercise test and heart rate curve, ratings of perceived exertion （RPE） curve, blood pressure curve during exercise test were determined before and after the experiment. Results ： There were no significant difference of baseline variables between the two groups （ P 〉 0. 05 ）, which had comparability between groups. After the experiment, body weight （ P 〈 0.05 ）, BMI （ P 〈 0.01 ）, percentage of body fat （P 〈0.0l ） and rest heart rate were reduced;in all kinds of blood pressure indexes,SBP and DBP of24h ABP declined by 5mmHg （ P 〈 0.01 ） and 3mmHg （ P 〈 0.01 ）, SBP and DBP of daytime ABP by 6mmHg （ P 〈 0.01 ） and 4mmHg （ P 〈 0.01 ）, but nighttime blood pressure and OBP had no significant difference; arterial compliance （ C1 and C2 ） had no change statistically （P 〉0.05） ;VO2max increased significantly （P 〈0.01 ） ;heart rate curve,ratings of perceived ex- ertion （RPE） curve,blood pressure curve during exercise test shifted right in exercise group. However, all indexes in con- trol group showed no significantly change （ P 〉 0.05 ）. Conclusion： Sixteen-week endurance training prescription could ef- fectively lower blood pressure and enhance exercise capacity in refractory hypertension patients.