Division of Cardiology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada.
Sports Med. 2014 Mar;44(3):345-56. doi: 10.1007/s40279-013-0118-x.
Hypertension, or the chronic elevation in resting arterial blood pressure (BP), is a significant risk factor for cardiovascular disease and estimated to affect ~1 billion adults worldwide. The goals of treatment are to lower BP through lifestyle modifications (smoking cessation, weight loss, exercise training, healthy eating and reduced sodium intake), and if not solely effective, the addition of antihypertensive medications. In particular, increased physical exercise and decreased sedentarism are important strategies in the prevention and management of hypertension. Current guidelines recommend both aerobic and dynamic resistance exercise training modalities to reduce BP. Mounting prospective evidence suggests that isometric exercise training in normotensive and hypertensive (medicated and non-medicated) cohorts of young and old participants may produce similar, if not greater, reductions in BP, with meta-analyses reporting mean reductions of between 10 and 13 mmHg systolic, and 6 and 8 mmHg diastolic. Isometric exercise training protocols typically consist of four sets of 2-min handgrip or leg contractions sustained at 20-50 % of maximal voluntary contraction, with each set separated by a rest period of 1-4 min. Training is usually completed three to five times per week for 4-10 weeks. Although the mechanisms responsible for these adaptations remain to be fully clarified, improvements in conduit and resistance vessel endothelium-dependent dilation, oxidative stress, and autonomic regulation of heart rate and BP have been reported. The clinical significance of isometric exercise training, as a time-efficient and effective training modality to reduce BP, warrants further study. This evidence-based review aims to summarize the current state of knowledge regarding the effects of isometric exercise training on resting BP.
高血压，或静息动脉血压（BP）的慢性升高，是心血管疾病的一个重要危险因素，据估计影响着全世界约 10 亿成年人。治疗的目标是通过生活方式的改变（戒烟、减肥、锻炼、健康饮食和减少钠的摄入）来降低血压，如果单纯的生活方式改变不奏效，就需要加入降压药物。特别是，增加体育锻炼和减少久坐行为是预防和治疗高血压的重要策略。目前的指南建议进行有氧运动和动力性抗阻运动训练，以降低血压。越来越多的前瞻性证据表明，在年轻和老年的正常血压和高血压（接受药物治疗和未接受药物治疗）人群中进行等长运动训练可能会产生类似的、甚至更大的降压效果，荟萃分析报告收缩压平均降低 10-13mmHg，舒张压降低 6-8mmHg。等长运动训练方案通常包括四组持续 2 分钟的手握或腿部收缩，收缩强度为最大自主收缩的 20-50%，每组之间休息 1-4 分钟。训练通常每周进行 3-5 次，持续 4-10 周。虽然这些适应的机制仍有待完全阐明，但已报道了管腔和阻力血管内皮依赖性扩张、氧化应激以及心率和血压的自主调节的改善。等长运动训练作为一种有效的降压训练方式，具有时间效率高的特点，其临床意义值得进一步研究。本循证综述旨在总结目前关于等长运动训练对静息血压影响的知识现状。
