Improving Blood Pressure & Vascular risk with resistance exercise in African Americans

非洲裔美国人的高血压发病率是世界上最高的。有效的治疗和意识 非裔美国人的高血压在过去十年中有所下降，这进一步加剧了种族差异， 心血管（CV）疾病发生率和死亡率与高加索人相比。此外，传统 建议通过饮食和有氧运动进行高血压的生活方式管理，这是基于数据 从大多数涉及高加索人的研究中获得。没有运动处方指南， 改善非洲裔美国人的血压， 人口仍然是个问题。我们实验室最近的一项研究表明， 运动训练对非裔美国人血压和动脉功能的影响 抗阻运动可能比有氧运动对早期血管风险产生更有益的影响。因此，在本发明中， 我们研究计划的目标是确定新的运动干预措施， 非裔美国人高血压前期和1期患者的动脉功能和血压降低。整体 这一建议的假设是，患有高血压前期和1期高血压的非洲裔美国人将 阻力运动训练对动脉功能和血压有更大的益处， 比有氧运动受益更长。相反，在白种人中，有氧运动将改善动脉功能 和降低心血管风险的效果更好。目标1将测试以下方面的比较有效性： 8-数周的阻力或有氧运动训练和停止训练对非裔美国人血压的影响， 与高加索人相比，这将通过前瞻性、随机、8 在非裔美国人中进行为期8周的阻力与有氧运动训练干预，随后停止训练 和高加索成年人（18 - 45岁）。目标2将测试8周抵抗的比较有效性 或有氧运动训练和停止训练对24小时动态血压和动脉僵硬度的影响， 非裔美国人与高加索人相比的中央和外周动脉。目标3将决定 8周抗阻或有氧运动训练和停训对动脉功能的影响 高血压前期和1期非裔美国人与高加索人相比的管道和阻力动脉。 这将在大动脉（肱动脉FMD）和小动脉（孤立阻力动脉扩张至 乙酰胆碱和流动）动脉。动脉功能的体内测定和 阻力动脉功能的生理途径与高血压的发病机制高度相关。 这些研究将有助于确定阻力训练后改善血管健康的部位和来源， 非裔美国人和高加索人。相关性：本研究将提供关于血液如何 压力可以通过运动最佳地降低，并且可能表明阻力运动训练是生活方式 非裔美国人降低血压的首选干预措施。

African Americans have the highest rates of hypertension in the world. Effective therapies and awareness of hypertension in African Americans have declined this past decade contributing to further racial disparities in cardiovascular (CV) disease rates and mortality compared to Caucasians. Further, the traditional recommendation for lifestyle management of hypertension with diet and aerobic exercise is based on data obtained from studies involving mostly Caucasians. There are no exercise prescription guidelines for improving blood pressure specific for African Americans and the management of hypertension in this population continues to be problematic. A recent study in our laboratory showed divergent effects of resistance exercise training on blood pressure and arterial function in African Americans compared to Caucasians indicating that resistance exercise may exert more beneficial effects than aerobic exercise on early vascular risk. Thus, the goal of our research program is to determine novel exercise interventions, designed to optimally target arterial function and lower blood pressure in African Americans with pre and stage 1 hypertension. The overall hypothesis of this proposal is that is that African Americans with pre-hypertension and stage 1 hypertension will show greater benefit from resistance exercise training on arterial function and blood pressure and retain the benefit longer than aerobic exercise. Conversely, in Caucasians, aerobic exercise will improve arterial function and reduce cardiovascular risk more than resistance exercise. Aim 1 will test the comparative effectiveness of 8-weeks of resistance or aerobic exercise training and de-training on blood pressure in African Americans with pre- and stage 1 hypertension compared to Caucasians. This will be tested with a prospective, randomized, 8 week resistance vs. aerobic exercise training intervention followed by 8 weeks of detraining in African American and Caucasian adults (18-45 years old). Aim 2 will test the comparative effectiveness of 8-weeks of resistance or aerobic exercise training and de-training on 24 hour ambulatory blood pressure and arterial stiffness in central and peripheral arteries in African Americans compared to Caucasians. Aim 3 will determine the effectiveness of 8-weeks of resistance or aerobic exercise training and de-training on arterial function in conduit and resistance arteries of pre- and stage 1 hypertensive African Americans compared to Caucasians. This will be determined in large (brachial artery FMD) and in small (dilation of isolated resistance arteries to acetylcholine and flow) arteries obtained from subcutaneous fat. In vivo determination of arterial function and physiologic approaches of resistance artery functioning are highly relevant to the pathogenesis of hypertension. These studies will serve determine the site and source of improved vascular health after resistance training in African Americans and Caucasians. Relevance: This study will provide clinically important data on how blood pressure can be optimally lowered by exercise and may show that resistance exercise training is the lifestyle intervention of choice for blood pressure lowering in African Americans.