Cooper A R, Moore L A, McKenna J, Riddoch C J
Department of Exercise and Health Sciences, University of Bristol.
Br J Gen Pract. 2000 Dec;50(461):958-62.
Current guidelines for the management of hypertension recommend regular, moderate intensity aerobic exercise such as brisk walking as a means of blood pressure reduction. However, there is a lack of consistent evidence regarding the magnitude of blood pressure response to such a prescription. In particular, no well designed studies have investigated the efficacy of a programme of exercise meeting current guidelines.
To investigate the effect of a six-week programme of moderate intensity exercise on daytime ambulatory blood pressure (10.00 am to 10.00 pm) among unmedicated, sedentary adults aged 25 years to 63 years with office blood pressure of 150 mmHg to 180 mmHg systolic and/or 91 mmHg to 110 mmHg diastolic.
Randomised controlled trial of participants carrying out 30 minutes of moderate intensity exercise (brisk walking or equivalent) five days per week for six weeks compared with controls who maintained existing levels of physical activity.
Compliance with the exercise programme was high. The reduction in mean daytime ambulatory blood pressure between baseline and six-week follow-up was greater in the intervention group than in the control group for both systolic and diastolic blood pressure. However, this net hypotensive effect was not statistically significant (systolic = -3.4 mmHg, 95% CI = -7.4 to 0.6; diastolic = -2.8 mmHg, 95% CI = -5.8 to 0.2). Adjusting for baseline differences in mean ambulatory blood pressure in an analysis of covariance led to a reduction in the estimated magnitude of the effect (systolic = -1.9 mmHg, 95% CI = -5.4 to 1.7, P = 0.31; diastolic = -2.2 mmHg, 95% CI = -4.9 to 0.5, P = 0.11).
Despite high compliance with the exercise programme, the magnitude of the hypotensive effect of moderate intensity exercise was not as great as that found in studies of higher intensity exercise among hypertensives. Expectations of general practitioners and patients that a programme of moderate intensity exercise will lead to a clinically important reduction in the individual's blood pressure are unlikely to be realised.
当前高血压管理指南推荐定期进行中等强度有氧运动，如快走，作为降低血压的一种方法。然而，关于这种运动处方对血压反应程度的证据并不一致。特别是，没有精心设计的研究调查符合当前指南的运动计划的效果。
研究一项为期六周的中等强度运动计划对年龄在25岁至63岁、未服药、久坐不动、办公室收缩压为150 mmHg至180 mmHg和/或舒张压为91 mmHg至110 mmHg的成年人日间动态血压（上午10:00至晚上10:00）的影响。
进行一项随机对照试验，参与者每周五天进行30分钟中等强度运动（快走或等效运动），持续六周，与保持现有身体活动水平的对照组进行比较。
运动计划的依从性很高。干预组收缩压和舒张压从基线到六周随访期间的平均日间动态血压下降幅度均大于对照组。然而，这种净降压效果在统计学上并不显著（收缩压=-3.4 mmHg，95%CI=-7.4至0.6；舒张压=-2.8 mmHg，95%CI=-5.8至0.2）。在协方差分析中对平均动态血压的基线差异进行调整后，估计效果的幅度有所降低（收缩压=-1.9 mmHg，95%CI=-5.4至1.7，P=0.31；舒张压=-2.2 mmHg，95%CI=-4.9至0.5，P=0.11）。
尽管对运动计划的依从性很高，但中等强度运动的降压效果幅度不如高血压患者高强度运动研究中发现的那样大。全科医生和患者期望中等强度运动计划能使个体血压在临床上显著降低，这种期望不太可能实现。
