Is cardiovascular fitness aerobic or why anaerobic
Cardiovascular effects of aerobic endurance training of the upper extremity
Aerobic endurance exercise is recommended worldwide as a useful antihypertensive therapy. However, many older hypertensive patients are prevented from practicing sports such as cycling or running because they suffer from walking problems due to musculoskeletal or vaso-occlusive diseases. This randomized and controlled study examined the effect of aerobic endurance training of the arms on the cardiovascular system. 24 patients were randomized into a training group and a control group. The members of the training group went through a 12-week training session on ergometers of the upper extremities (“arm bikes”), which was adjusted to a lactate concentration of 2.0 ± 0.5 mmol / l. In all patients, blood pressure, endothelial function (measured as FMD [flow mediated dilation]), arterial stiffness (measured in compliance of the large and small arterial vessels [C1, C2] and augmentation index) and examined the maximum resilience during classic and arm bike ergometry. The training program led to a significant blood pressure reduction of systolic 7.0 ± 9.1 mmHg (p = 0.03) and diastolic 5.9 ± 7.4 mmHg (p = 0.02) as well as a significant improvement in compliance of small arteries (C2) of 3.5 ± 1.6 to 4.8 ± 2.0 ml / mmHg x 100. The endothelial function (FMD), the compliance of large arteries (C1) and the augmentation index were not significantly changed. The general physical endurance in bicycle ergometry remained stable, while the maximum endurance of the patients in the training group in arm bicycle ergometry increased significantly (p = 0.005). In the control group, all parameters examined remained unchanged. Regular heart rate and lactate-controlled arm bike training leads to a significant reduction in systolic and diastolic blood pressure and improved compliance of small arteries in older hypertensive patients. As an alternative to sports such as jogging or cycling, it can also be recommended for patients with walking difficulties who want to control their arterial hypertension with the help of non-medicinal measures.
Aerobic exercise is recommended as a means to lower blood pressure in hypertensive patients. Many of those, however, are limited by musculoskeletal complaints or vascular occlusive disease from lower-limb exercise such as jogging or cycling. In the present randomized-controlled study, we evaluate whether an aerobic arm-cycling program provides a measurable cardiovascular benefit. Twenty-four probands were randomly assigned to sedentary activity or a heart rate controlled 12 week exercise program, consisting of arm-cycling at target lactate concentrations of 2.0 +/- 0.5 mmol / l. Endothelial function was assessed by flow-mediated dilation of the brachial artery. Augmentation index and large / small artery compliance (C (1) and C (2)) were measured by computerized pulse-wave analysis of the radial artery. The exercise program led to a significant reduction in systolic (134.0 +/- 20.0 to 127.0 +/- 16.4 mmHg; P = 0.03) and diastolic blood pressure (73.0 +/- 21.6 to 67.1 +/- 8.2 mmHg; P = 0.02) accompanied by a significant improvement in C (2) (3.5 +/- 1.6 to 4.8 +/- 2.0 ml / mmHg x 100; P = 0.004). Flow-mediated dilation, augmentation index, and C (2) were not significantly affected (P> 0.05). Physical performance as derived from lactate and heart rate curves of lower-limb stress tests was unchanged, whereas maximal workload in an upper-limb ergometry significantly increased (P = 0.005). Blood pressure and vascular parameters remained unchanged in the control group. Regular arm aerobic exercise leads to a marked reduction in systolic and diastolic blood pressures and an improvement in small artery compliance. Arm-cycling is a reasonable option for hypertensive patients who want to support blood pressure control by sports despite having coxarthrosis, gonarthrosis, or intermittent claudication.
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