Exercise and weight loss reduce blood pressure in men and women with mild hypertension - Effects on cardiovascular, metabolic, and hemodynamic functioning
Exercise and weight loss reduce blood pressure in men and women with mild hypertension - Effects on cardiovascular, metabolic, and hemodynamic functioning
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DOI：
10.1001/archinte.160.13.1947
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发表时间：
2000-07-10
影响因子：
--
通讯作者：
Hinderliter, A
中科院分区：
文献类型：
--
作者：
Blumenthal, JA;Sherwood, A;Hinderliter, A
背景：改变生活方式已被推荐作为降低高血压（BP）的初始治疗策略。然而，关于运动和减肥在高血压治疗中的有效性的证据仍存在争议。方法：133 名久坐、超重、未接受药物治疗的正常高血压或 1 至 2 期高血压的男性和女性被随机分配至仅进行有氧运动；行为体重管理计划，包括锻炼；或等候名单对照组。治疗前后，在诊所、日常生活、运动和精神压力测试期间测量收缩压和舒张压。还评估了血流动力学测量和代谢功能。 结果：尽管两个积极治疗组的参与者相对于对照组的血压均显着降低，但体重管理组的参与者通常降幅更大。与有氧运动相关的收缩压和舒张压降低 4 毫米汞柱相比，体重管理与临床血压降低 7 毫米汞柱和舒张压降低 5 毫米汞柱相关；对照的 BP 没有改变。与对照组相比，两个治疗组的参与者还表现出外周阻力降低和心输出量增加，其中体重管理组的外周阻力降低幅度最大。体重管理参与者的空腹和餐后血糖和胰岛素水平也显着低于其他组的参与者。结论：虽然单独运动可以有效降低血压，但添加行为减肥计划可以增强这种效果。建议将有氧运动与减肥相结合来控制久坐、超重个体的血压升高。
Background: Lifestyle modifications have been recommended as the initial treatment strategy for lowering high blood pressure (BP). However, evidence for the efficacy of exercise and weight loss in the management of high BP remains controversial.Methods: One hundred thirty-three sedentary, overweight men and women with unmedicated high normal BP or stage 1 to 2 hypertension were randomly assigned to aerobic exercise only; a behavioral weight management program, including exercise; or a waiting list control group. Before and following treatment, systolic and diastolic BPs were measured in the clinic, during daily life, and during exercise and mental stress testing. Hemodynamic measures and metabolic functioning also were assessed.Results: Although participants in both active treatment groups exhibited significant reductions in BP relative to controls, those in the weight management group generally had larger reductions. Weight management was associated with a 7-mm Hg systolic and a 5-mm Hg diastolic clinic BP reduction, compared with a 4-mm Hg systolic and diastolic BP reduction associated with aerobic exercise; the BP for controls did not change. Participants in both treatment groups also displayed reduced peripheral resistance and increased cardiac output compared with controls, with the greatest reductions in peripheral resistance in those in the weight management group. Weight management participants also exhibited significantly lower fasting and postprandial glucose and insulin levels than participants in the other groups.Conclusions: Although exercise alone was effective in reducing BP, the addition of a behavioral weight loss program enhanced this effect. Aerobic exercise combined with weight loss is recommended for the management of elevated BP in sedentary, overweight individuals.