不同規律運動族群於單次最大運動後血壓、血管硬度與血流動力學反應之差異研究

Abstract

背景：運動常作為血壓調控的非侵入式治療之一，相較於有氧運動長期被證實能夠改善心血管系統，過去研究指出阻力運動卻可能會對心血管系統帶來負面效應。運動前血壓值是運動後低血壓反應 (post-exercise hypotension, PEH) 中重要的調節因子 (moderator)，顯示規律運動習慣造成的心血管安靜值差異，可能使運動後心血管反應有所差異。目的：探討不同規律運動習慣的族群進行最大腳踏車運動後，血壓及血流動力學各項指標的變化；並分析運動習慣的不同，是否造成最大運動引起之運動後低血壓反應會有所差異。方法：以橫斷式研究設計，共招募71位年齡介於20至40歲之健康成年人，依運動習慣分為無規律運動組 (N=33)、有氧訓練組 (N=17)、阻力訓練組 (N=21)，進行腳踏車最大運動測試，並於運動前、運動後5分鐘、運動後15分鐘及30分鐘，進行血壓及橈、頸動脈波形測量。結果：阻力訓練組之安靜bSBP、cZc、cPf及rXSPI顯著高於其他兩組 (p< .05)。運動後任一時間點之bSBP與baPWV、cPf、rPeak_Pr、rRPI及rXSPI都呈中度相關 (r皆大於.3)。結論：長期規律阻力訓練確實可能使動脈硬度上升，且使部分血流動力學指標於最大運動後之反應有顯著差異。另外，動脈波形分析之水庫理論，與運動後血壓變化之相關性較高，顯示以水庫理論較能解釋運動後心血管變化情形。

Background: Exercise has been one of the non-invasive treatments for blood pressure regulation. Compared with aerobic exercise which has been proven to improve the cardiovascular function, resistance training may have an adverse impact on cardiovascular system. Pre-exercise blood pressure is an important moderator of post-exercise hypotension. It shows that different BP status, caused by different exercise habits, may bring differences in arterial responses after exercise. Purpose: To evaluate blood pressure, arterial stiffness, and hemodynamics following a maximal aerobic exercise test between groups having different exercise habits. Also, to investigate whether the difference of exercise habits would cause post-exercise hypotension variation after maximal aerobic exercise. Methods: We did a cross-sectional study in 71 healthy adults (aged 20-40 years) with different exercise habits, including the non-exercisers (NE, N = 33), regular aerobic trainers (RAT, N = 17) and regular resistance trainers (RRT, N = 21). Participants underwent an acute bout of graded maximal aerobic exercise. Blood pressure (BP), arterial stiffness, and arterial hemodynamics were measured at baseline, 5-, 15- and 30-min after exercise. Results: RRT group had significantly higher resting bSBP, cZc, cPf and rXSPI than the other groups (p < .05). baPWV, cPf, rPeak_Pr, rRPI and rXSPI showed a moderate correlation with bSBP any time after exercise (r > .3). Conclusion: Regularly engaging in RRT exercise has positive association with higher arterial stiffness. And it does show some differences in arterial hemodynamics responses after exercise between NE, RAT and RRT groups. Overall indices derived from arterial reservoir hemodynamics correlated better with the PEH compared to traditional wave reflection theory. Our research provides evidences supporting that arterial reservoir hemodynamics has proposed a more reasonable explanation for the observed BP changes after exercise.