Hypertensive response to exercise: mechanisms and clinical implication.
Hypertensive response to exercise: mechanisms and clinical implication.
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DOI：
10.1186/s40885-016-0052-y
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发表时间：
2016
影响因子：
4.2
通讯作者：
Ha JW
中科院分区：
文献类型：
--
作者：
Kim D;Ha JW
高血压对运动的反应（HRE）在没有高血压或其他心血管疾病的个体中经常观察到。然而，HRE的机制和临床意义尚未完全阐明。内皮功能障碍和大动脉僵硬度增加有助于HRE的发展。从神经激素方面看，交感神经系统的过度刺激和血管紧张素II的升高可能是HRE的重要机制。越来越多的证据表明，HRE与左心室功能和结构异常有关，特别是当伴有中心血压升高时。HRE对高血压的未来发展和心血管事件的增加具有预后意义，特别是在中等强度运动中记录的HRE。既往研究表明，HRE并不是一种良性现象，但目前对HRE的治疗存在争议，治疗策略也不确定。考虑到潜在的机制，血管紧张素受体阻滞剂和β受体阻滞剂可以推荐用于HRE患者，然而，关于HRE治疗在非高血压患者中的疗效和结果的证据很少，因此需要进一步研究。
A hypertensive response to exercise (HRE) is frequently observed in individuals without hypertension or other cardiovascular disease. However, mechanisms and clinical implication of HRE is not fully elucidated. Endothelial dysfunction and increased stiffness of large artery contribute to development of HRE. From neurohormonal aspects, excess stimulation of sympathetic nervous system and augmented rise of angiotensin II seems to be important mechanism in HRE. Increasing evidences indicates that a HRE is associated with functional and structural abnormalities of left ventricle, especially when accompanied by increased central blood pressure. A HRE harbors prognostic significance in future development of hypertension and increased cardiovascular events, particularly if a HRE is documented in moderate intensity of exercise. As supported by previous studies, a HRE is not a benign phenomenon, however, currently, whether to treat a HRE is controversial with uncertain treatment strategy. Considering underlying mechanisms, angiotensin receptor blockers and beta blockers can be suggested in individuals with HRE, however, evidences for efficacy and outcomes of treatment of HRE in individuals without hypertension is scarce and therefore warrants further studies.