Circulation:生活方式改变对顽固性高血压患者的影响

2021-09-27 MedSci原创 MedSci原创

饮食和运动可以降低顽固性高血压患者的血压。这项为期4个月的结构化饮食和运动计划作为心脏康复治疗中的辅助治疗,可显著降低血压和动态血压,并改善选定的心血管疾病生物标志物。

虽然改变生活方式通常可有效降低未经治疗的高血压患者以及接受1或2种降压药治疗的患者的血压(BP),但运动和饮食对难治性高血压患者降血压的效果尚未明确。

近日,血管领域权威杂志Circulation上发表了一篇研究文章,140名顽固性高血压患者(平均年龄为63岁;48%为女性;59%为黑人;31%为糖尿病患者;21%为慢性肾病患者)被随机分配到一个为期4个月的生活方式改变计划(C-LIFE[以中心为基础的生活方式干预]),包括饮食咨询、行为体重管理和锻炼,或提供SEPA(标准化教育和医师建议)。

该研究的主要终点为临床收缩压;次要终点包括24小时动态血压和选择的心血管疾病生物标志物,包括压力反射敏感性以量化压力反射对心率的影响,高频心率变异性以评估迷走神经介导的心率控制、血流介导的扩张以评估内皮功能、脉搏波速度以评估动脉僵硬度,以及左心室质量以明确左心室结构。

组间比较发现,与SEPA(–7.1[–95%CI为10.4至–3.7]mmHg)相比(P=0.005),C-LIFE组患者收缩压降低更明显(–12.5 [95%CI为-14.9至-10.2]mmHg),此外,24小时动态收缩压也降低(–7.0[95%CI为–8.5至–4.0]mmHg),而SEPA组患者没有变化(–0.3[95%CI为–4.0至3.4]mmHg)(P=0.001)。与SEPA相比,C-LIFE组患者显著改善静息压力反射敏感性(2.3ms/mmHg[95%CI为1.3to3.3] vs. –1.1ms/mmHg[95%CI为–2.5to0.3];P<0.001)、高频心率变异性(0.4 lnms2[95%CI为0.2至0.6]与–0.2 lnms2[95%CI为–0.5至0.1];P<0.001)和血流介导的扩张(0.3%[95%CI为–0.3至1.0]与–1.4%[95%CI为–2.5至–0.3];P=0.022)。脉搏波速度(P=0.958)或左心室质量(P=0.596)没有组间差异。

由此可见,饮食和运动可以降低顽固性高血压患者的血压。这项为期4个月的结构化饮食和运动计划作为心脏康复治疗中的辅助治疗,可显著降低血压和动态血压,并改善选定的心血管疾病生物标志物。

原始出处:

James A. Blumenthal,et al.Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial.Circulation. 2021.https://doi.org/10.1161/CIRCULATIONAHA.121.055329

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    2022-08-20 小小医者

    #顽固性高血压#,能用#生活方式#调节,就太厉害了

    0

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    2021-09-28 查查佳佳

    佛罗就算了算了,

    0

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    2021-09-28 水流风

    好评

    0

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