Assessment of Cardiovascular Parameters on Submaximal Treadmill Exercise in Obese versus Nonobese Adults.

Pub Date : 2023-10-01 Epub Date: 2023-12-08 DOI:10.4103/ijabmr.ijabmr_290_23
Aditya Gupta, Ravinder Garg, Sumit Pal Singh Chawla, Sarabjot Kaur, Shiwali Goyal
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Abstract

Background: Obesity and overweight, irrespective of metabolic status, confer an increased risk of adverse consequences including cardiovascular diseases (CVDs). The mechanisms underlying altered cardiovascular responses in obese individuals during and after submaximal treadmill exercise are the subjects of great interest to public health. After graded exercise, delayed heart rate recovery (HRR), exaggerated blood pressure (BP) response, and prolongation of QT interval are the powerful predictors of cardiovascular morbidity and mortality that may facilitate timely identification of individuals at risk of CVD and help to evaluate the effectiveness of treatment interventions.

Aim: To compare the cardiovascular parameters on submaximal treadmill exercise in obese and nonobese adults.

Materials and methods: This study was conducted on 80 subjects, 40 obese (cases) and 40 normal-weight individuals (controls), belonging to the age group of 18-60 years. Each participant was subjected to submaximal treadmill exercise according to the Bruce protocol. Heart rate (HR), systolic BP and diastolic BP (SBP and DBP), mean arterial pressure (MAP), QT and corrected QT (QTc) intervals, and rate pressure product (RPP) were measured preexercise, immediately after exercise, and during passive recovery at 1 min and 5 min after exercise. The Chi-square test and Mann-Whitney U-test, whichever is appropriate, were employed for the comparison of variables between the two study groups. P < 0.05 was considered statistically significant.

Results: Mean HR immediately after exercise, at 1 min and 5 min postexercise was significantly higher in obese when compared to nonobese participants (P = 0.006, P = 0.001, P = 0.001) despite similar resting HR in both the groups (P = 0.874). Mean SBP, DBP, MAP, and RPP were significantly higher in obese in comparison to nonobese subjects in all stages, i.e. before exercise, immediately after exercise, at 1 min and 5 min after exercise. QT and QTc intervals were also found to be significantly greater in obese than nonobese subjects in all stages (P = 0.001 each).

Conclusion: Obese subjects had higher resting BP (SBP, DBP, and MAP), QT/QTc interval, RPP, and increased response to submaximal treadmill exercise activity. Delayed HRR after exercise was also noted in obese subjects which indicates that obese populations are at risk of developing CVDs due to alteration in autonomic functions with sympathetic hyperactivity.

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评估肥胖与非肥胖成人在亚最大跑步机运动中的心血管参数。
背景:无论代谢状况如何,肥胖和超重都会增加包括心血管疾病在内的不良后果的风险。肥胖者在亚极限跑步机运动期间和运动后心血管反应发生改变的机制是公共卫生领域非常关注的问题。分级运动后,延迟的心率恢复(HRR)、夸张的血压(BP)反应和 QT 间期延长是心血管疾病发病率和死亡率的有力预测指标,有助于及时识别心血管疾病高危人群,并帮助评估治疗干预措施的有效性:研究对象为 80 名年龄在 18-60 岁之间的受试者,其中 40 名肥胖者(病例)和 40 名体重正常者(对照组)。每位受试者都按照布鲁斯方案进行了亚极限跑步机运动。分别在运动前、运动后立即以及运动后 1 分钟和 5 分钟被动恢复期间测量心率(HR)、收缩压和舒张压(SBP 和 DBP)、平均动脉压(MAP)、QT 和校正 QT(QTc)间期以及率压乘积(RPP)。在比较两个研究组之间的变量时,采用了卡方检验(Chi-square test)和曼-惠特尼U检验(Mann-Whitney U-test)。P<0.05为差异有统计学意义:结果:尽管两组参与者的静息心率相似(P = 0.874),但肥胖者运动后立即、运动后 1 分钟和 5 分钟的平均心率明显高于非肥胖者(P = 0.006、P = 0.001、P = 0.001)。在运动前、运动后即刻、运动后 1 分钟和 5 分钟等所有阶段,肥胖者的平均 SBP、DBP、MAP 和 RPP 均明显高于非肥胖者。肥胖者的 QT 和 QTc 间期在所有阶段都明显高于非肥胖者(P = 0.001):结论:肥胖受试者的静息血压(SBP、DBP 和 MAP)、QT/QTc 间期、RPP 均较高,对亚极限跑步机运动活动的反应也较强。肥胖受试者运动后的 HRR 也有所延迟,这表明肥胖人群由于交感神经功能亢进而导致自律神经功能改变,因而有罹患心血管疾病的风险。
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