Exercise training for blood pressure: a systematic review and meta-analysis.
Exercise training for blood pressure: a systematic review and meta-analysis.
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DOI：
10.1161/jaha.112.004473
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发表时间：
2013-02-01
影响因子：
5.4
通讯作者：
Smart NA
中科院分区：
文献类型：
--
作者：
Cornelissen VA;Smart NA
我们进行了荟萃分析，研究耐力训练、动态抗阻训练、耐力与抗阻联合训练以及等长抗阻训练对成年人静息血压（BP）的影响。目的是量化并比较每种训练方式的血压变化，并确定血压变化最大的患者亚组。
纳入了截至2012年2月发表在同行评审期刊上的、持续时间≥4周的研究运动对健康成年人（年龄≥18岁）血压影响的随机对照试验。分析采用随机效应模型，数据以加权均值和95%置信区间报告。我们纳入了93项试验，涉及105个耐力训练组、29个动态抗阻训练组、14个联合训练组和5个等长抗阻训练组，总计5223名参与者（3401名运动组和1822名对照组）。耐力训练（−3.5 mmHg[置信区间−4.6至−2.3]）、动态抗阻训练（−1.8 mmHg[−3.7至−0.011]）和等长抗阻训练（−10.9 mmHg[−14.5至−7.4]）后收缩压（SBP）降低，但联合训练后未降低。耐力训练（−2.5 mmHg[−3.2至−1.7]）、动态抗阻训练（−3.2 mmHg[−4.5至−2.0]）、等长抗阻训练（−6.2 mmHg[−10.3至−2.0]）和联合训练（−2.2 mmHg[−3.9至−0.48]）后舒张压（DBP）降低。在26个高血压受试者研究组中，耐力训练后的血压降低幅度（P<0.0001）（−8.3[−10.7至−6.0]/−5.2[−6.8至−3.4] mmHg）大于50个高血压前期受试者组（−2.1[−3.3至−0.83]/−1.7[−2.7至−0.68]）和29个血压正常受试者组（−0.75[−2.2至+0.69]/−1.1[−2.2至−0.068]）。与高血压或血压正常患者相比，高血压前期参与者在动态抗阻训练后的血压降低幅度最大（−4.0[−7.4至−0.5]/−3.8[−5.7至−1.9] mmHg）。
耐力训练、动态抗阻训练和等长抗阻训练可降低收缩压和舒张压，而联合训练仅降低舒张压。少数等长抗阻训练研究的数据表明，这种训练形式有可能使收缩压降低幅度最大。
We conducted meta‐analyses examining the effects of endurance, dynamic resistance, combined endurance and resistance training, and isometric resistance training on resting blood pressure (BP) in adults. The aims were to quantify and compare BP changes for each training modality and identify patient subgroups exhibiting the largest BP changes. Randomized controlled trials lasting ≥4 weeks investigating the effects of exercise on BP in healthy adults (age ≥18 years) and published in a peer‐reviewed journal up to February 2012 were included. Random effects models were used for analyses, with data reported as weighted means and 95% confidence interval. We included 93 trials, involving 105 endurance, 29 dynamic resistance, 14 combined, and 5 isometric resistance groups, totaling 5223 participants (3401 exercise and 1822 control). Systolic BP (SBP) was reduced after endurance (−3.5 mm Hg [confidence limits −4.6 to −2.3]), dynamic resistance (−1.8 mm Hg [−3.7 to −0.011]), and isometric resistance (−10.9 mm Hg [−14.5 to −7.4]) but not after combined training. Reductions in diastolic BP (DBP) were observed after endurance (−2.5 mm Hg [−3.2 to −1.7]), dynamic resistance (−3.2 mm Hg [−4.5 to −2.0]), isometric resistance (−6.2 mm Hg [−10.3 to −2.0]), and combined (−2.2 mm Hg [−3.9 to −0.48]) training. BP reductions after endurance training were greater (P<0.0001) in 26 study groups of hypertensive subjects (−8.3 [−10.7 to −6.0]/−5.2 [−6.8 to −3.4] mm Hg) than in 50 groups of prehypertensive subjects (−2.1 [−3.3 to −0.83]/−1.7 [−2.7 to −0.68]) and 29 groups of subjects with normal BP levels (−0.75 [−2.2 to +0.69]/−1.1 [−2.2 to −0.068]). BP reductions after dynamic resistance training were largest for prehypertensive participants (−4.0 [−7.4 to −0.5]/−3.8 [−5.7 to −1.9] mm Hg) compared with patients with hypertension or normal BP. Endurance, dynamic resistance, and isometric resistance training lower SBP and DBP, whereas combined training lowers only DBP. Data from a small number of isometric resistance training studies suggest this form of training has the potential for the largest reductions in SBP.