高血壓病患進行中度運動之短期與長期效應

Short-Term and Long-Term Effects of Moderate Intensity Exercise in Hypertensive Patients

本研究評估高血壓病患運動之安全性與有效性。運動組10位高血壓病患依規劃進行運動，對照組10位則否。運動以50%~85%最大心跳儲備值（HRmaxRev）為強度，每週2次，每次60分鐘，為期三個月。兩組於三個月前後均測量其最大攝氧量（VO2max），休息時心跳、血壓、與血脂濃度；運動時測量其運動當時的心跳血壓反應與熱量消耗。數據顯示個案達到50%~85% HRmaxRev之運動量為其最大攝氧量之55%±13%，約是5.5±1.1MET，屬中度運動；此運動使個案血壓升高，尤以前一個月及前10分鐘的熱身期為甚，但心跳不會超過120次／分、收縮壓不會超過220mmHg，舒張壓不會超過110mmHg，一旦熱身足、身體逐漸適應運動，血壓有下降的趨勢。50%~85%最大心跳儲備值的運動強度使個案每次有300Kcal以上的熱量消耗。如此運動三個月體重與血脂均無明顯變化；運動組平均心跳減少3.7次／分，平均收縮壓下降17.5mmHg，平均舒張壓下降8.8mmHg，達統計上意義，心肺適能尚無明顯變化；對照組休息時心跳血壓無明顯變化，最大攝氧量則下降10%，達統計上意義。本研究顯示中度運動對高血壓病人是安全的，且能有效降低血壓與維持心肺適能；指導高血壓病患保健運動時，須強調熱身運動之重要性，在運動初期1個月及前10分鐘需加強血壓過度升高之監測，以維護運動之安全。

The purpose of this study is to investigate the safety and effectiveness of moderate intensity exercise training on hypertensive patients. Subjects were recruited from hypertensive clinic, 10 in exercise group and 10 in comparison group. The exercise group conducted 50%~85% HRmaxRev exercise for 60 minutes twice a week for three months. Before and after the 3-month interval, each subject received treadmill test and serum lipids evaluation. During exercise, the blood pressures of the subjects were taken every 5~10 minutes. The results were as following. The intensity of exercise at level of 50%~85% HRmaxRev is about 55+13% of VO2max and is about 5.5+1.1 MET. Blood pressure increased during exercise, especially in the first 10-minutes of warm-up period. The highest blood pressure developed in the first month and then lowered down in the following months. The total calories consumed were above 300Kcal at 50%~85% HRmaxRev exercise for 60 minutes. Before and after the 3-month interval, subjects in both groups had no significant change in body weight and serum lipids levels. Subjects in exercise group had significant reduction of resting heart rate (3.7 bpm), SBP (17.5 mmHg) and DBP (8.8 mmHg), with insignificant increase in VO2max . Subjects in the comparison group did not have any significant change in body weight, serum lipids levels, resting heart rate, and blood pressure. The VO2max decreased 10% significantly (p<0.05). This study demonstrated that moderate intensity exercise was effective for reducing blood pressure and preserving cardiopulmonary fitness for hypertensive patients. For safety, patients need to be supervised for blood pressure change in the beginning stage, especially during their warming-up process.