| Objective:The unique role of scientific and rational aerobic exercise in exerting potential risk factors for prevention and treatment of cardiovascular diseases has become a method actively recommended by experts at home and abroad.For the design of exercise prescriptions for cardiovascular diseases,operability should be considered on the premise of being safe and effective.However,the current exercise prescriptions generally have problems such as insufficient exercise intensity or large-scale promotion,which limits the role of exercise prescription.As an easy-to-execute exercise,it is not limited to time,place and technology,and is widely used as the first choice for prevention and treatment of hypertension and other cardiovascular diseases.In this study,the micro-mepometer was used to control the subject's stride frequency for a 12-week walking exercise.The effects of walking exercise on vascular function and exercise blood pressure in patients with essential hypertension were discussed.The patients with essential hypertension were reduced for aerobic exercise.Provide theoretical and experimental evidence for cardiovascular disease risk;provide a reference for the development of scientific and reasonable exercise prescriptions for patients with essential hypertension.Methods:1.SubjectsThe subjects were from four communities(Yongqing Yicun Community,Yongqing Ercun Community,Haijiang Second Village Community,Qinggang Road Community)under the jurisdiction of Wusong Street Community Health Service Center.The community doctors collected patients with essential hypertension who visited the community health service center from June 2015 to June 2016 according to the residents' health records and residents' willingness to participate.Another 30 healthy subjects with normal blood pressure were also recruited.Based on the subject sample evaluation,subject inclusion and exclusion criteria,46 subjects with essential hypertension and 23 healthy subjects with normal blood pressure were screened.According to the random principle,46 subjects with essential hypertension were randomly divided into 2 groups,23 in each group,one group was exercise training group(ETG group),participated in 12-week walking intervention;the other group was positive control group(PCG group),do not participate in walking intervention.23 healthy subjects with normal blood pressure as the negative control group(NCG group),do not interfere with lifestyle.According to the shedding criteria,after the 12-week walking intervention,3 people were lost in the NCG and ETG groups,and 1 in the PCG group.2.InterventionDetermination of maximal oxygen uptake by subjects using the Astrand test protocol.Determine the relationship between oxygen uptake and stride frequency through a modified 6MWT:,Where X represents the step frequency.The exercise intensity was 45% to 50% of the maximal oxygen uptake,substituting the above formulas,the step frequency of exercise intervention can be calculated by substituting the above formulas.The ETG group wears a micro metronome for no less than three times a week,45-60 minutes of walking exercise for a total of 12 weeks.3.Indicator measurementIndicators include morphological indicators(height,weight,circumference,body fat rate);daily physical activity indicators(daily walking,daily sedentary time,different intensity physical activity time,daily physical exertion);lipid metabolism indicators(TG,TC,LDL-c,HDL-c);exercise capacity index(maximum oxygen uptake,heart rate);blood pressure(quiet and exercise state);vascular endothelial function index(related diastolic index: NO,eNOS;related contraction index: ET-1,Renin,Ang II;related vascular endothelial injury indicators: EMPs,SOD,hs-CRP);arterial stiffness index(AI index,baPWV).Before and after exercise intervention,using ActiGraph GT3X+ to Monitor the Daily Exercise Volume of Subjects.Measurement of Blood Pressure after Different Exercise State by Omron Electronic Sphygmomanometer.Measurement of Body Fat Rate by InBody 720.Determination of baPWV using the Japanese OMRON VP-1000(BP-203RPEII)atherosclerometer.Determination of TC,TG,HDL-c and LDL-c by automatic biochemical analyzer.Determination of ET-1,eNOS,NO,Renin and Ang II by Enzyme-linked immunosorbent assay.Determination of hs-CRP by latex enhanced immunoturbidimetry.Determination of vascular endothelial particle CD62E(+)EMPs by flow cytometry(BD FACSCalibur,USA).The Chinese version of SF-36 translated by the Department of Social Medicine of Zhejiang University School of Medicine was used as a concise health questionnaire to evaluate the quality of life of the subjects.4.Data Processing MethodData Processing Using Spss 20.0 Data Package.Single-factor Anova analysis was used to compare the two groups before intervention.Covariance analysis was used to compare the two groups before intervention.LSD test was used to compare the two groups.Paired sample T test was used to compare the effects before and after intervention.Paired T test was used to compare the effects before and after intervention.Assessment of sample size before intervention using G*Power.Results:1.Body shape index:Before exercise intervention,waist circumference,WHR,BMI and body fat rate in NCG group were significantly lower than those in PCG group and ETG group(P<0.05),while there was no significant difference between PCG group and ETG group(P>0.05).After exercise intervention,waist circumference,WHR and body fat rate in ETG group were significantly higher than those in NCG group,and body shape indexes in ETG group were significant better than those in PCG group(P<0.05)Compared with before exercise intervention,waist circumference,WHR,BMI and body fat rate in ETG group decreased significant(P<0.05),while hip circumference increased significant(P<0.05).2.Daily physical activity indicators:Before exercise intervention,the daily walking volume,medium-intensity physical activity time,and daily energy expenditure of the NCG group were significantly higher than those of the PCG group and the ETG group(P<0.05),and the sedentary time was significantly lower than the PCG.Group and ETG group(P <0.05);PCG group and ETG group daily walking volume,medium intensity physical activity time,sedentary time and daily energy consumption were not statistically different(P>0.05),ETG group daily walking after exercise intervention There was no significant difference in sedentary time between the sedentary time and the NCG group(P>0.05).The medium-intensity physical activity time and physical activity energy expenditure were significantly higher than those in the NCG group(P<0.05).The ETG group daily walking amount,daily energy expenditure The medium-intensity physical activity time was significantly higher than that in the PCG group(P<0.05).The sedentary time and the small-intensity physical activity time were significantly lower than those in the PCG group(P<0.05).Compared with before exercise intervention,the daily energy consumption,daily energy intensity,and daily energy expenditure of the ETG group were significantly increased(P<0.05),and the sedentary time decreased significantly(P <0.05).3.Exercise capacity index:Before exercise intervention,the maximal oxygen uptake in the NCG group was significantly higher than that in the PCG group and the ETG group,and the resting heart rate was significantly less than the two groups;there was no significant difference in the maximal oxygen uptake and resting heart rate between the PCG group and the ETG group(P>0.05).After exercise intervention,there was no significant difference in quiet HR and maximal oxygen uptake between the ETG group and the NCG group(P>0.05).The maximum oxygen uptake in the ETG group was significantly higher than that in the PCG group(P<0.05),and the quiet HR was significantly lower.PCG group(P<0.05).Compared with before exercise intervention,the maximal oxygen uptake was significantly increased in the ETG group,and the resting heart rate was significantly lower(P<0.05).4.Lipid metabolism index:Before exercise intervention,TC and TG in NCG group were significantly lower than PCG group and ETG group(P<0.05),HDL-c was significantly higher than the two groups(P<0.05),LDL-c and PCG.There was no significant difference between the group and the ETG group(P>0.05).There were no significant differences in TC,TG,HDL-c and LDL-c between the PCG group and the ETG group(P>0.05).After exercise intervention,TC,TG,and LDL-c were significantly lower in the ETG group than in the PCG group,and HDL-c was significantly higher than the PCG group(P<0.05).The LDL-c in the ETG group was significantly lower than that in the NCG group(P< 0.05),there was no significant difference between TC,TG,HDL-c and NCG group(P>0.05).Compared with before exercise intervention,ET,TG,LDL-c were significantly decreased in the ETG group(P<0.05),and HDL-c was significantly increased(P<0.05).5.Exercise blood pressure index:Before exercise intervention,the SBP and DBP of the NCG group in three exercise states(quiet,low intensity,high intensity)were significantly lower than those of the PCG group and the ETG group(P<0.05);There was no significant difference in SBP and DBP between the ETG groups(P>0.05).After exercise intervention,SBP and DBP in ETG group were significantly lower than those in PCG group(P<0.05),but were significantly higher than NCG group(P<0.05).SBP and DBP in PCG group were in three kinds of exercise.The status was still significantly higher than the NCG group(P<0.05).Compared with before exercise intervention,the SBP of the three groups in the ETG group decreased significantly(P<0.05),and the change of DBP was not statistically significant(P>0.05).6.Vascular endothelial function indicators:1)Vasodilator factors released by vascular endothelium: Before exercise intervention,the concentration of NO and eNOS in NCG group was significantly higher than that in PCG group and ETG group(P<0.05);the concentration of NO and eNOS in PCG group and ETG group had no statistical significance(P>0.05).After exercise intervention,the concentration of NO and eNOS in PCG group was significantly lower than that in NCG group and ETG group(P<0.05),and there was no significant difference between ETG group and NCG group(P>0.05).Compared with before exercise intervention,the concentration of NO and eNOS in ETG group increased significantly(P<0.05).2)Vascular endothelial contractile substances released: Before exercise intervention,the concentrations of ET-1,Renin and Ang II in NCG group were significantly lower than those in PCG group and ETG group(P<0.05);there was no significant difference in the concentrations of ET-1,Renin and Ang II between PCG group and ETG group(P>0.05).After exercise intervention,the concentrations of ET-1,Renin and Ang II in PCG group were significantly higher than those in NCG group and ETG group(P<0.05),while the concentrations of ET-1,Renin and Ang II in ETG group were not significantly different from those in NCG group(P > 0.05).Compared with before exercise intervention,ET-1 and Renin concentration in ETG group decreased significantly(P<0.05),while Ang II concentration did not decrease significantly(P>0.05).3)Indicators related to vascular endothelial injury: Before exercise intervention,the concentrations of EMPs and hs-CRP in NCG group were significantly lower than those in PCG group and ETG group(P<0.05),and the concentrations of EMPs,hs-CRP and SOD in PCG group and ETG group had no statistical difference(P>0.05).After exercise intervention,the concentration of EMPs and hs-CRP in PCG group was significantly higher than that in NCG group and ETG group(P<0.05),and the concentration of SOD was significantly lower than that in ETG group(P<0.05);the concentration of EMPs and hs-CRP in ETG group was significantly higher than that in NCG group(P<0.05),and the concentration of SOD was not significantly different from that in NCG group(P>0.05).Compared with before exercise intervention,the concentration of SOD in ETG group increased significantly(P<0.05),but the concentration of EMPs and hs-CRP did not decrease significantly(P>0.05).7.Arterial stiffness index: Before exercise intervention,AI and baPWV in NCG group were significantly lower than those in PCG group and ETG group;AI and baPWV in PCG group and ETG group had no statistical difference.After exercise intervention,AI and baPWV in ETG group were significantly lower than those in PCG group(P<0.05),but significantly higher than those in NCG group(P<0.05).Compared with before exercise intervention,AI and baPWV in ETG group decreased significantly(P<0.05).8.Indicator correlation:1)The correlation between exercise blood pressure and various indicators: Two different intensity step quantitative load test exercise SBP was positively correlated with TC,TG,quiet SBP,quiet DBP,WHR,BMI,body fat rate and sedentary time,while moderately negatively correlated with HDL-c,different intensity physical activity time and physical exertion.The exercise DBP of two different intensity step quantitative load tests was positively correlated with TC,TG,quiet SBP,quiet DBP,WHR,BMI and sedentary time,but negatively correlated with HDL-c,different intensity physical activity time and physical consumption.2)The correlation between vascular endothelial function and various indexesEndothelial relaxant NO and eNOS were negatively correlated with TC,TG,quiet blood pressure,WHR and sedentary time,and positively correlated with walking volume,moderate intensity PA time and physical energy consumption.Endothelial contractile substances ET-1 and Ang II were positively correlated with TC,TG,quiet blood pressure,WHR and sedentary time,negatively correlated with walking volume and different PA time.EMPs and hs-CRP were positively correlated with TC,TG,quiet blood pressure,WHR,BMI and sedentary time,but negatively correlated with HDL-c,walking volume,moderate PA,high PA and physical exertion.Endothelial injury index SOD was negatively correlated with TC,TG,quiet blood pressure,WHR and sedentary time,and positively correlated with walking volume,moderate PA time and physical exertion.3)The correlation between arterial stiffness index and various indexesAI and baPWV were positively correlated with TC,TG,quiet blood pressure,WHR,sedentary time,and negatively correlated with HDL-c,walking volume,PA time of different intensity and physical exertion.4)Relevance of Exercise Blood Pressure,Vascular Endothelial Function and Arterial StiffnessSBP in exercise blood pressure was negatively correlated with NO and eNOS,and positively correlated with ET-1 and Ang II,negatively correlated with SOD,positively correlated with EMPs and hs-CRP,and positively correlated with AI and baPWV.NO and eNOS were moderately negatively correlated with ET-1 and Ang II,moderately negatively correlated with EMPs and hs-CRP,moderately positively correlated with SOD,and moderately negatively correlated with AI and baPWV.ET-1 and Ang II were positively correlated with EMPs and hs-CRP,moderately negatively correlated with SOD,and moderately positively correlated with AI and baPWV.AI index of arterial stiffness and baPWV were positively correlated with exercise blood pressure and vasoconstrictor,but negatively correlated with vasodilator and SOD in endothelial injury.Conclusion: Appropriate walking exercise after 12 weeks,1.The exercise ability,daily physical activity,lipid metabolism,body fat rate and abdominal fat accumulation of patients with essential hypertension were improved,and the risk factors of hypertension were reduced.2.The decrease of quiet systolic blood pressure,pulse pressure difference,exercise blood pressure and its increase in patients with essential hypertension may reduce the risk of acute cardiovascular events during intensive exercise.3.The damage of vascular endothelium in patients with essential hypertension decreases,and the balance of endothelial cell secretion prevents the development of atherosclerosis.4.The arterial stiffness of patients with essential hypertension decreases,which reduces the possibility of target organ damage. |
PDF Full Text Request