Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors
Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors
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DOI：
10.1161/01.hyp.0000184225.05629.51
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发表时间：
2005-10-01
期刊：
影响因子：
8.3
通讯作者：
Fagard, RH
中科院分区：
文献类型：
--
作者：
Cornelissen, VA;Fagard, RH
以前关于慢性动态有氧耐力训练对血压影响的随机对照试验的荟萃分析仅报告了静息血压。我们的目的是进行一项全面的荟萃分析，包括静息和动态血压，血压调节机制，以及伴随的心血管危险因素。研究的入选标准是：随机分配到干预和对照组;耐力训练作为唯一的干预;纳入健康的久坐不动的血压正常或高血压成人;干预持续时间>= 4周;收缩压或舒张压的可用性;以及截至2003年12月在同行评审期刊上发表的文章。该荟萃分析涉及72项试验，105个研究组和3936名参与者。在对训练参与者的数量进行加权并使用随机效应模型后，训练引起静息和日间动态血压的显著净降低，分别为3.0/2.4 mm He（P < 0.001）和3.3/3.5 mm Hg（P < 0.01）。30个高血压研究组的静息血压下降（-6.9/-4.9）比其他组（-1.9/-1.6; P < 0.001）更明显。体循环阻力降低7.1%（P < 0.05），血浆去甲肾上腺素降低29%（P < 0.001），血浆肾素活性降低20%（P < 0.05）。体重下降1.2kg（P < 0.001），腰围下降2.8cm（P < 0.001），体脂百分比下降1.4%（P < 0.001），胰岛素抵抗稳态模型评估指数下降0.31U（P < 0.01），高密度脂蛋白胆固醇升高0.032mmol/L-1（P < 0.05）。总之，有氧耐力训练通过降低血管阻力来降低血压，其中交感神经系统和肾素-血管紧张素系统似乎参与其中，并有利地影响伴随的心血管危险因素。
Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure-regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of >= 4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm He, (P < 0.001) and 3.3/3.5 mm Hg (P < 0.01). The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (-6.9/-4.9) than in the others (-1.9/-1.6; P < 0.001 for all). Systemic vascular resistance decreased by 7.1% (P < 0.05), plasma norepinephrine by 29% (P < 0.001), and plasma renin activity by 20% (P < 0.05). Body weight decreased by 1.2 kg (P < 0.001), waist circumference by 2.8 cm (P < 0.001), percent body fat by 1.4% (P < 0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U (P < 0.01); HDL cholesterol increased by 0.032 mmol/L-1 (P < 0.05). In conclusion, aerobic endurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors.