高血壓的非藥物治療策略：等長收縮與缺血預處理

Non-pharmacological strategy for hypertension: Isometric training and ischemic precondition

等長收縮訓練屬於阻力訓練的一種，在過去的運動指導中常被認為應被高血壓患者所避免，然而近年來逐漸有研究認為在適當的控制下進行反而能夠有效地降低血壓。而缺血預處理相似於等長收縮訓練，都是血流限制的一種形式，其中的共同點為都改善血管內皮功能，這對於血壓調節有很大的幫助。本研究透過相關文獻的搜尋與整理，探討等長收縮訓練和缺血預處理在急性與非急性介入時對血壓的影響，並試圖尋找作為高血壓非藥物治療的新策略。綜合過去研究發現，長期的等長收縮訓練對降血壓有一致性的效果，在急性介入的研究中雖有立即性的改變但持續時間非常短暫；非急性的缺血預處理對收縮壓的下降具有顯著效果，且不論患者是否患有高血壓。相較於等長收縮，缺血預處理是屬於被動將血管血流限制，能夠更完全的阻斷血流，推測可能會有更佳的改善空間，然而目前尚未有研究比較等長收縮與缺血預處理兩者對血壓改善的作用。以等長收縮訓練或者缺血預處理作為一種非藥物的血壓改善策略是獲得研究證實且安全有效的，特別是缺血預處理是透過自動充氣壓脈帶使血管被動性收縮，過程可控性高，或許是未來可以更加推行的策略。

Isometric training is a kind of resistance training. However, some of the hypertension guidelines have not recommended isometric training as an exercise prescription for hypertension. The present research performed a significant decrease of blood pressure by a proper exercise prescription. In fact, both ischemic precondition (IPC) and isometrics training is considered as blood flow restriction (BFR), which have in common to improve endothelial cell function and blood pressure regulation. The objective of our study is to examine the effect of acute or non-acute treatment for both isometric training and ischemic precondition in blood pressure response, and develop a strategy for non-pharmacological treatment of hypertension. A number of studies have indicated, long-term isometric training showed consistency in reducing the blood pressure, whereas the acute condition showed an immediacy change in a short period; A non-acute IPC led to a significant reduction of systolic blood pressure with or without hypertension. In comparison with isometric training, IPC has conducted a passive in resistance of vessel endothelial, which may completely restrict the vessel. The comparison between IPC and isometric training in reduction of blood pressure has not found yet, but we speculated that the IPC conduct a greater reduction of blood pressure than isometric training. In conclusion, both IPC and isometric training was performed as a non-pharmacological therapy to lower blood pressure with safety and effectiveness. Especially, IPC was designed as an automatic inflatable cuff, it may become an important feature in the future.