Dynamic Resistance Training as Stand-Alone Antihypertensive Lifestyle Therapy: A Meta-Analysis.
Dynamic Resistance Training as Stand-Alone Antihypertensive Lifestyle Therapy: A Meta-Analysis.
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DOI：
10.1161/jaha.116.003231
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发表时间：
2016-09-28
影响因子：
5.4
通讯作者：
Pescatello LS
中科院分区：
文献类型：
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作者：
MacDonald HV;Johnson BT;Huedo-Medina TB;Livingston J;Forsyth KC;Kraemer WJ;Farinatti PT;Pescatello LS
有氧运动（AE）被推荐为一线抗高血压生活方式治疗，因为有强有力的证据表明，它可以降低高血压成人的血压（BP）5至7 mm Hg。由于较弱的证据表明，动态阻力训练（RT）降低血压2至3毫米汞柱的成人高血压，它被推荐为辅助生活方式治疗AE训练。然而，现有的证据表明，动态RT可以降低血压一样多或超过AE。我们Meta分析了64项对照研究（71项干预措施），以确定动态RT作为独立降压治疗的疗效。受试者（N=2344）为白色（57%）、中年（47.2±19.0岁）和超重（26.8±3.4 kg/m2）成人，患有高血压前期（126.7±10.3/76.8±8.7 mm Hg）; 15%正在接受降压药物治疗。总体而言，中等强度动态RT进行了2.8±0.6天/周，持续14.4±7.9周，并引起收缩压轻微至中度降低（SBP; d+=−0.31; 95% CI，−0.43，−0.19; −3.0 mm Hg）和舒张压（DBP; d+=−0.30; 95% CI，−0.38，−0.18; −2.1 mm Hg）与对照组相比（Ps<0.001）。在静息SBP/DBP较高的样本中，血压下降幅度更大：高血压为1.6/5 mm Hg，高血压前期为1.3/3 mm Hg，正常血压为1.0/1 mm Hg（P <0.023）。此外，非白人高血压患者的血压下降幅度约为之前报告的AE培训后血压下降幅度的两倍（−14.3 mm Hg [95% CI，−19.0，−9.4]/−10.3 mm Hg [95% CI，−14.5，−6.2]）。我们的研究结果表明，对于非白人高血压成人样本，动态RT可能会引起血压下降，相当于或大于那些报道的AE训练。应进一步研究动态RT作为高血压成人人群可行的独立治疗性运动选择。
Aerobic exercise (AE) is recommended as first‐line antihypertensive lifestyle therapy based on strong evidence showing that it lowers blood pressure (BP) 5 to 7 mm Hg among adults with hypertension. Because of weaker evidence showing that dynamic resistance training (RT) reduces BP 2 to 3 mm Hg among adults with hypertension, it is recommended as adjuvant lifestyle therapy to AE training. Yet, existing evidence suggests that dynamic RT can lower BP as much or more than AE. We meta‐analyzed 64 controlled studies (71 interventions) to determine the efficacy of dynamic RT as stand‐alone antihypertensive therapy. Participants (N=2344) were white (57%), middle‐aged (47.2±19.0 years), and overweight (26.8±3.4 kg/m2) adults with prehypertension (126.7±10.3/76.8±8.7 mm Hg); 15% were on antihypertensive medication. Overall, moderate‐intensity dynamic RT was performed 2.8±0.6 days/week for 14.4±7.9 weeks and elicited small‐to‐moderate reductions in systolic BP (SBP; d+=−0.31; 95% CIs, −0.43, −0.19; −3.0 mm Hg) and diastolic BP (DBP; d+=−0.30; 95% CIs, −0.38, −0.18; −2.1 mm Hg) compared to controls (Ps<0.001). Greater BP reductions occurred among samples with higher resting SBP/DBP: ≈6/5 mm Hg for hypertension, ≈3/3 mm Hg for prehypertension, and ≈0/1 mm Hg for normal BP (Ps<0.023). Furthermore, nonwhite samples with hypertension experienced BP reductions that were approximately twice the magnitude of those previously reported following AE training (−14.3 mm Hg [95% CIs, −19.0, −9.4]/−10.3 mm Hg [95% CIs, −14.5, −6.2]). Our results indicate that for nonwhite adult samples with hypertension, dynamic RT may elicit BP reductions that are comparable to or greater than those reportedly achieved with AE training. Dynamic RT should be further investigated as a viable stand‐alone therapeutic exercise option for adult populations with high BP.