有氧運動前增補咖啡因對男女性高血壓患者運動後血壓及脈波傳導速率之影響

Abstract

背景：高血壓是導致心血管疾病的主要危險因子，有氧運動對降低血壓與脈波傳導速率有益，但運動前增補咖啡因可能抵銷健康成人運動後低血壓 (Post Exercise Hypotension, PEH) 的效益，且性別在血壓調控、心血管風險與咖啡因敏感性也可能存在差異。目的：探討男、女性高血壓患者在有氧運動前增補咖啡因對運動後低血壓及肱踝脈波傳導速率 (brachial-ankle pulse wave velocity, baPWV) 的影響。方法：招募20名無規律運動、無咖啡因攝取習慣且未服用藥物的高血壓患者 (10名男性、10名女性；33.7 ± 8.4歲，收縮壓139.8 ± 9.2 mmHg，舒張壓87.3 ± 10.9 mmHg)，以雙盲、重複量數及平衡次序之方式進行每公斤體重3毫克之咖啡因 (CAF) 或安慰劑 (PLA) 膠囊增補處理後休息30分鐘，接續進行30分鐘，強度為70% 儲備心率的跑步機運動，並於基準值、運動前、運動後30、60、90及120分鐘進行血壓、baPWV測量，同時採集血液，分析內皮型一氧化氮合成酶 (eNOS) 及內皮素-1 (ET-1)。結果：性別、處理與時間三因子對血壓、baPWV及血液指標無顯著交互作用。僅處理與時間因子在收縮壓、舒張壓及平均動脈壓的交互作用達顯著 (p< .05)，咖啡因處理的收縮壓與平均動脈壓在運動後30、60及90分鐘皆顯著高於安慰劑處理，舒張壓則是在運動後30與60分鐘顯著高於安慰劑處理；另外，踝肱血壓指數 (ABI)、baPWV及血液指標 eNOS 與 ET-1 的交互作用皆未達顯著。結論：有氧運動前增補每公斤體重 3 毫克的咖啡因會顯著提升高血壓患者的血壓及脈波傳導速率，並抵消運動後的降壓效益，然而，單次運動後並未造成baPWV的顯著下降，且上述效應在性別間無明顯差異。Background: Hypertension is a major cardiovascular risk factor. While aerobic exercise reduces blood pressure (BP) and pulse wave velocity (PWV), pre-exercise caffeine supplementation may offset the benefits of post-exercise hypotension (PEH) in healthy adults. Sex differences in BP regulation and caffeine sensitivity necessitate further exploration. Purpose: To examine the effects of pre-exercise caffeine on post-exercise BP and baPWV in hypertensive men and women. Method: Twenty hypertensive adults (10 males, 10 females; 33.7 ± 8.4 years; SBP: 139.8 ± 9.2 mmHg; DBP: 87.3 ± 10.9 mmHg) with no regular exercise habits, no caffeine consumption habits, and not taking any medications participated in a double-blind, repeated-measures trial. Participants ingested 3 mg/kg caffeine or placebo 30 minutes before a 30-minute treadmill exercise at 70% heart rate reserve. BP and baPWV were measured at baseline, pre-exercise, and 30, 60, 90, and 120 minutes post-exercise. Blood markers (eNOS, ET-1) were also analyzed. Results: Caffeine significantly increased BP post-exercise (30, 60 and 90 min for SBP and MAP, 30 and 60 min for DBP) compared to placebo. No significant effects were found for ABI, baPWV, or blood markers. Conclusion: Pre-exercise caffeine (3 mg/kg) offsets the PEH of aerobic exercise in hypertensive patients and does not reduce baPWV. These effects were consistent across sexes.