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

非洲裔美国人的高血压患病率是世界上最高的。有效的治疗方法和意识 在过去的十年里，非裔美国人的高血压患病率有所下降，这进一步加剧了 与高加索人相比，心血管(CV)患病率和死亡率。此外，传统的 饮食和有氧运动对高血压患者生活方式管理的建议是基于数据 从主要涉及高加索人的研究中获得。目前还没有运动处方指南 改善非裔美国人特有的血压和高血压的管理 人口仍然是个问题。我们实验室最近的一项研究显示了抗性的不同影响 运动训练对非裔美国人和高加索人血压和动脉功能的影响 在早期血管风险方面，抗阻运动可能比有氧运动起到更好的作用。因此， 我们研究计划的目标是确定新的运动干预措施，旨在优化目标 患有前期和1期高血压的非裔美国人的动脉功能和较低的血压。整体而言 这一提议的假设是，患有高血压前期和1期高血压的非裔美国人将 显示阻力运动训练对动脉功能和血压有更大的好处，并保持 比有氧运动受益的时间更长。相反，在高加索人中，有氧运动会改善动脉功能 比抵抗运动更能降低心血管风险。目标1将测试以下各项的比较有效性 8周阻力或有氧运动训练和非裔美国人对血压的影响 与高加索人相比，高血压前期和阶段1。这将用前瞻性的、随机的、8 非裔美国人的周阻力与有氧运动训练干预后8周的脱训 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 有氧运动训练和去训练对24小时动态血压和动脉僵硬的影响 与高加索人相比，非裔美国人的中央和外周动脉。目标3将决定 8周抗阻或有氧运动训练与去训练对大鼠动脉功能的影响 高血压前期和1期非裔美国人与高加索人的管道和阻力动脉的比较。 这将在大的(臂动脉FMD)和小的(孤立的阻力动脉扩张到 从皮下脂肪中获取的动脉。动脉功能的活体测定和 阻力动脉功能的生理途径与高血压的发病机制密切相关。 这些研究将有助于确定阻力训练后血管健康改善的部位和来源 非裔美国人和白种人。相关性：这项研究将提供重要的临床数据 通过运动可以最佳地降低压力，并可能表明抗阻运动训练是一种生活方式 非裔美国人选择的降压干预措施。

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.