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Patients with mild hypertension have systemic microvascular sparse, individualized motion schemes can reduce blood pressure levels | ACC 2019

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Microvascular sparseness (MVR) is an important pathological change of hypertension. By increasing vascular resistance and improving micro -environment, the development of target organs damage. Existing evidence shows that medium -intensity exercise can reduce blood pressure and improve endothelial function to a certain extent. Moreover, endothelial ancestral cells (EPCS) have an important role in maintaining the stability of vascular endothelial stability. However, whether exercise can improve the EPCS function to improve hypertension MVR deficiency Related research.

At the ACC 2019 meeting, a study submitted by Dr. Liang Jianwen, the eighth hospital affiliated to Sun Yat -sen University, showed that there were systemic microvascular sparse patients with mild hypertension and can be discovered by the Octa combined fingers. The plan can significantly reduce the blood pressure level of patients with mild hypertension.

Study introduction

In this study, 35 patients who were young (25-40 years old) and 35 patients who had not treated with drugs and 35 health volunteers with age matching. And the bottom of the eye OCT detection of the retinal microvascular density (RCD) and the non-irrigation area (R-NPA) evaluation system microcirculation irrigation situation; after the cardiopulmonary motion test (CPET), patients with hypertension (CPET), moderate intensity motion (power bicycle resistance platform mode, motion motion, motion, motion The strength is 70%of the maximum motion tolerance METS, 5 times/week, the time of each exercise is allocated at 3 minutes, 45 minutes of resistance exercise and 10 minutes recovery, about 3000 kcal/week) intervention for 12 weeks. Detecting the function of EPCS before and after exercise and analyzes the relationship between the signal channels of the Notch-ENOS signal.

The results of the research suggest that the SCD and RCDs of patients with hypertension are reduced compared with healthy volunteers (P <0.05), the R-NPA is significantly increased (P 0.64 of SCD, P 0.64 of SCD, P <0.001)]; The group decreases, the level of the NOTCH1 receptor of cells has increased, and ENOS expression levels have declined.

After the intervention of medium -intensity exercise, the systolic and diastolic pressure of patients with hypertension decreased significantly compared with before exercise (SBP: 133.11 ± 6.65 mmHg vs. 142.86 ± 8.36 mmHg, P <0.01; DBP: 80.4 ± 5.46 mmHg vs. 86.84 ± ± ± 5.83 mmHg, P <0.01), RCD increased significantly compared with before exercise, R-NPA was significantly reduced, and the exercise capacity, oxygen intake and left heart diastolic function of patients with hypertension were significantly improved. Moreover, the ability of blood vessels has increased significantly, the expression level of Notch1 has decreased, ENOS expression levels have increased significantly, and notch is the upstream signal of the ENOS-NO signal.

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For the first time, this study revealed that patients with mild hypertension have systemic microvascular sparse and can be discovered by the OCTA combined fingertips. The detection efficiency of OCTA is better than the trend of traditional fingering microscope. The blood pressure level of patients with blood pressure improves the sparse micro-vascular sparse EPCS function improvement of the NOTCH-ENOS signaling pathway.

As a member of the team of Professor Wu Guifu, Dr. Liang Jianwen currently hosted the “Enhanced In vitro Conduct for Coronary Heart Disease Patients with Myocardial Micro Circulation” project ” 200 patients with coronary heart disease combined with diabetes, and the microcirculation resistance index (IMR) determined by the pressure guide wire to evaluate myocardial microcirculation disorders. On the basis of standardized coronary heart disease secondary prevention The efficacy of microcirculation disorders has now completed registration and pre -testing. It is expected that the research results will provide clinical evidence for the diagnosis and treatment of myocardial microcirculation disorders of coronary heart disease and diabetic patients.

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