TREATMENT OF HYPERTENSION WITH TWO EXERCISE INTENSITIES

用两种运动强度治疗高血压

基本信息

批准号：
6183770
负责人：
JOEL D POSNER
金额：
$ 48.12万
依托单位：
MCP HAHNEMANN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
1997
资助国家：
美国
起止时间：
1997-06-15 至 2002-05-31
项目状态：
已结题

项目摘要

DESCRIPTION: (Adapted from Investigator's Abstract) Arterial hypertension affects over 50 million Americans. While drug treatment is effective, exercise would be safer, might be cheaper, and would bring added health benefits if it could replace drugs in controlling hypertension. The aims of this study are to: 1) determine if two 18 month long endurance training programs, one of high intensity and one of moderate intensity, can replace medication as a treatment for mild essential hypertension, 2) determine if a moderate intensity endurance training program is as effective as or more effective than a high intensity program in allowing mild essential hypertensives to discontinue anti-hypertensive medication, 3) determine if physiological, psychological, and compliance variables predict success in allowing mild essential hypertensives to discontinue anti-hypertensive medication. The investigators propose a randomized controlled trial. Known hypertensives (n=162) whose diastolic blood pressures rises to between 90 and 104 within four months of discontinuing medication under careful observation will have their pressures controlled with enalapril. Half the subjects will be female and half male, and their racial characteristics will generally reflect that of our managed care population (about 20% black). V02 peak will be measured during cycle ergometry. Eligible subjects will be randomly assigned to 18 months participation in one of three groups: 1) high intensity endurance training (35 minutes 3 times/week at heart rate at 70-85% of V02 peak), 2) moderate intensity endurance training (35 minutes 3 times/week at heart rate of 50-70 of V02 peak), and 3) contact control. Enalapril will be forward or back titrated or discontinued to maintain a normal blood pressure. After 12 months participation, medication will be withdrawn under careful supervision from all subjects still taking it. They will test the hypotheses that: 1) a greater number of subjects undergoing either or both of the two 18 month exercise training programs will be able to stop anti-hypertensive medication than non-exercising controls, 2) moderate and high intensity endurance training are equally effective in replacing drugs in the treatment of mild essential hypertension, and 3) subjects that are successful at withdrawing anti-hypertensive medication will have: greater improvements in V02 peak, better initial psychological status or greater improvements in psychological status, and greater compliance with the exercise training program. The investigators state that this study will be a critical test of whether endurance training can replace medication in an important number of patients as a treatment for hypertension.

描述：（改编自研究者摘要）动脉高血压影响超过 5000 万美国人。虽然药物治疗有效，锻炼会更安全，可能更便宜，而且会带来更多健康如果它可以替代控制高血压的药物，将会带来好处。的目标这项研究的目的是： 1) 确定是否进行两次 18 个月的长期耐力训练项目，一种高强度和一种中等强度，可以取代药物治疗轻度原发性高血压，2) 确定是否中等强度耐力训练计划的效果与以上相同或更高比高强度计划更有效地允许轻度必需品高血压患者应停止抗高血压药物，3) 确定是否生理、心理和依从性变量可预测成功允许轻度原发性高血压患者停止抗高血压药物药物。研究人员提出了一项随机对照试验。已知舒张压升至 90 之间的高血压患者 (n=162) 和 104 在谨慎停止用药后四个月内观察将用依那普利控制他们的压力。一半受试者将是女性和一半男性，他们的种族特征将总体反映了我们管理式医疗人群的情况（约 20% 是黑人）。 V02 峰值将在自行车测功期间测量。符合资格的科目将是随机分配到三组之一，为期 18 个月：1) 高强度耐力训练（35 分钟，每周 3 次，心率为 V02峰值的70-85%），2）中等强度耐力训练（35分钟3 次/周，心率为 V02 峰值 50-70)，以及 3) 接触控制。依那普利将向前或向后滴定或停止以维持正常血压。参与 12 个月后，将进行药物治疗在所有仍在服用该药的受试者的仔细监督下撤回。他们将测试以下假设：1）更多受试者接受两个为期 18 个月的运动训练计划中的一个或两个都能够与不运动对照相比，停止抗高血压药物，2) 中等强度和高强度的耐力训练同样有效替代治疗轻度原发性高血压的药物，以及 3) 成功戒断抗高血压药物的受试者将会有：V02峰值有更大的改善，更好的初始心理状态或心理状态的更大改善，以及更大的遵守运动训练计划。调查人员表示这项研究将是耐力训练能否取代耐力训练的关键测试大量患者接受药物治疗高血压。