Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial
Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial
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DOI：
10.1016/j.ijnurstu.2018.08.009
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发表时间：
2018-12-01
影响因子：
8.1
通讯作者：
Taylor-Piliae, Ruth E.
中科院分区：
文献类型：
--
作者：
Chan, Aileen Wai Kiu;Chair, Sek Ying;Taylor-Piliae, Ruth E.
背景：缺乏运动是与心血管疾病相关的可改变生活方式的主要危险因素。太极拳在老年人中是一种安全且受欢迎的体育活动形式，但在减少心血管疾病风险因素和改善社会心理健康方面，太极拳和快走的能力缺乏直接的比较。方法：246名成年人（平均年龄= 64.4±9.8岁，年龄范围= 30-91岁，45.5%男性）患有高血压和至少2个但不超过3个可改变的心血管疾病危险因素（糖尿病、血脂异常、超重、缺乏运动和吸烟），随机分为太极拳组（n = 82）、快走组（n = 82）或对照组（n = 82）。太极拳组和快走组每周进行150分钟中等强度体力活动，持续3个月；鼓励在接下来的6个月里每天在家练习。主要结果是血压。次要结局是空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白和低密度脂蛋白、体重指数、腰围、有氧耐力、感知压力、生活质量和运动自我效能。在基线、干预后3个月收集数据，在6个月和9个月进行随访评估。使用广义估计方程模型来比较各组间结果随时间的变化。结果：在基线时，参与者的平均血压= 141/81，平均体重指数= 26；58%为糖尿病患者，61%为血脂异常，11%为吸烟者。各组间无显著差异。与对照组相比，太极拳在9个月时显著降低血压（收缩压-13.33 mmHg；舒张压-6.45 mmHg）、空腹血糖（-0.72 mmol/L）、糖化血红蛋白（-0.39%）和感知压力（-3.22分），改善感知心理健康（+ 4.05分）和运动自我效能（+12.79分）。与快走组相比，太极拳组的血压（收缩压-12.46 mmHg；舒张压-3.20 mmHg），空腹血糖（-1.27 mmol/L），糖化血红蛋白（0.56%），感知压力（-2.32分）降低，感知心理健康（+3.54分）和运动自我效能（+12.83分）改善明显更大。其他心血管疾病风险指标在两组间未观察到显著变化。结论：护士在促进成人运动以降低心血管疾病风险和培养健康生活方式方面发挥着关键作用。在减少心血管疾病的危险因素和改善心理健康方面，太极拳比快走更好，可以作为一种可行的运动来推荐，以建立一个没有心血管疾病的健康生活。
Background: Physical inactivity is a major modifiable lifestyle risk factor associated with cardiovascular disease. Tai Chi is a safe and popular form of physical activity among older adults, yet direct comparisons are lacking between Tai Chi and brisk walking in their ability to reduce cardiovascular disease risk factors and improve psychosocial well-being.Methods: 246 adults (mean age = 64.4 +/- 9.8 years, age range = 30-91 years, 45.5% men) with hypertension and at least two but not more than three modifiable cardiovascular disease risk factors (diabetes, dyslipidaemia, overweight, physical inactivity and smoking) were randomly assigned to either Tai Chi (n = 82), brisk walking (n = 82) or control (n = 82) groups. The Tai Chi and brisk walking groups engaged in moderate-intensity physical activity 150 min/week for 3 months; daily home-based practice was encouraged for another 6 months. The primary outcome was blood pressure. Secondary outcomes were fasting blood sugar, glycated haemoglobin, total cholesterol, triglycerides, high- and low-density lipoprotein, body mass index, waist circumference, aerobic endurance, perceived stress, quality of life and exercise self-efficacy. Data were collected at baseline, post intervention at 3 months and follow-up assessments at 6 and 9 months. Generalised estimating equation models were used to compare the changes in outcomes over time between groups.Results: At baseline, the participants had an average blood pressure = 141/81 and average body mass index = 26; 58% were diabetics, 61% presented with dyslipidemia and 11% were smokers. No significant difference was noted between groups. Tai Chi significantly lowered blood pressure (systolic -13.33 mmHg; diastolic -6.45 mmHg), fasting blood sugar (-0.72 mmol/L), glycated haemoglobin (-0.39%) and perceived stress (-3.22 score) and improved perceived mental health (+ 4.05 score) and exercise self-efficacy (+12.79 score) at 9 months, compared to the control group. In the Tai Chi group, significantly greater reductions in blood pressure (systolic -12.46 mmHg; diastolic -3.20 mmHg), fasting blood sugar (-1.27 mmol/L), glycated haemoglobin (0.56%), lower perceived stress (-2.32 score), and improved perceived mental health (+3.54 score) and exercise self-efficacy (+12.83 score) were observed, compared to the brisk walking group. No significant changes in the other cardiovascular disease risk indicators were observed over time between groups.Conclusion: Nurses play a key role in promoting exercise to reduce cardiovascular disease risk and foster a healthy lifestyle among adults. Tai Chi is better than brisk walking in reducing several cardiovascular disease risk factors and improving psychosocial well-being, and can be recommended as a viable exercise for building a healthy life free of cardiovascular disease.