不同运动模式对原发性高血压患者运动耐力及心肌功能改善效果研究

Effect of different exercise modes on improving exercise endurance and myocardialfunction in patients with essential hypertension

目的 探讨不同运动模式对原发性高血压患者运动耐力及心肌功能改善效果。方法 选取2020年6月至2022年12月在中国人民解放军某医院就诊的原发性高血压患者180例,按照随机数字表法均分为高强度间歇有氧运动训练组(AIT组)和中低强度持续有氧运动训练组(MIT组)以及未进行运动训练安静对照组(Control组)共3组,每组均为60例,运动干预组患者运动训练持续12周。对比各组运动干预前、后的血压、心率(HR)、身体质量指数(BMI)、超声心动图指标及运动耐力变化。结果 180例患者中男119例,女61例;年龄35~87岁,平均(52.83±5.12)岁;BMI为18.2~36.9 kg/m2,平均(24.74±2.32)kg/m2;病程(4.96±0.98)年;高血压分级:Ⅰ级54例,Ⅱ级79例,Ⅲ级47例;服药依从性好者116例,服药依从性差者64例。3组患者的性别分布、年龄、病程、BMI、HR、收缩压(SBP)、舒张压(DBP)、血压分级、服药依从性等差异均无统计学意义(均P>0.05)。3组患者运动干预前SBP、DBP、HR、超声心动图指标、运动耐力指标差异均无统计学意义(均P>0.05)。3组患者SBP、DBP、HR、左心室质量指数(LVMI)、左心室舒张末期内径(LVDD)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、最大耗氧量(VO2)、代谢当量(METs)运动干预后以及干预前后差值的差异均有统计学意义(均P<0.01)。结论 运动对原发性高血压患者的降压作用具有强度依赖性。相比中低强度持续有氧运动,高强度间歇有氧运动的改善效果更佳,是降低血压和改善其他心血管危险因素的有效方法。

Objective To explore the effects of different exercise modes on improving exercise endurance and myocardial function in patients with essential hypertension.Methods A total of 180 patients with essential hypertension were selected from a certain hospital of the Chinese PLA General Hospital from June 2020 to December 2022.According to the method of random number table,the patients were divided into three groups:high‐intensity intermittent aerobic exercise training group(AIT group),moderate to low intensity continuous aerobic exercise training group(MIT group),and quiet control group(Control group)without exercise training,with 60 cases in each group.The exercise training lasted for 12 weeks in the exercise intervention group.Blood pressure,heart rate(HR),body mass index(BMI),echocardiogram,and exercise endurance were compared before and after exercise intervention.Results Among 180 patients,there were 119 males and 61 females,aged 35-87 years old,with an average of(52.83±5.12)years old.The BMI was 18.2-36.9 kg/m2,with an average of(24.74±2.32)kg/m2.The course of the disease was(4.96±0.98)years.Hypertension classification:54 cases at grade I,79 cases at gradeⅡ,and 47 cases at gradeⅢ.There were 116 cases with good medication adherence and 64 cases with poor medication adherence.There were no statistically significant differences in gender distribution,age,course of disease,BMI,HR,SBP,DBP,blood pressure grading,and medication adherence among the three groupsof patients(all P>0.05). There were no statistically significant differences in SBP,DBP,HR,echocardiography indicators,and exercise endurance indicators among the three groups of patients before exercise intervention(all P>0.05). Thedifferences in SBP,DBP,HR,left ventricular mass index(LVMI),left ventricular end diastolic diameter(LVDD),leftventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),maximum oxygen consumption(VO2),and metabolic equivalents(METs)among the three groups of patients after exercise intervention and beforeand after intervention were statistically significant(all P<0.01). Conclusions The antihypertensive effect of exercise isintensity dependent in patients with essential hypertension. Compared with moderate to low intensity continuous aerobic exercise,high‐intensity intermittent aerobic exercise has a better improvement effect and is an effective way to reduce bloodpressure and improve other cardiovascular risk factors.