Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada.
Sports Med. 2018 Sep;48(9):2127-2142. doi: 10.1007/s40279-018-0944-y.
Aerobic exercise reduces blood pressure (BP), but it is unknown whether a high-intensity training approach can elicit a greater BP reduction in populations with elevated BP. This systematic review compared the efficacy of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) for reducing BP in adults with pre- to established hypertension.
Five electronic databases (MEDLINE, EMBASE, CENTRAL, PEDro, and SPORTDiscus) were searched for randomized trials comparing the chronic effects of HIIT versus MICT on BP in individuals with resting systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 85 mmHg and/or under antihypertensive medication. Random-effects modelling was used to compare changes from pre- to post-intervention in resting and ambulatory BP between HIIT and MICT. Changes from pre- to post-intervention in maximal oxygen uptake ([Formula: see text]O) between HIIT and MICT were also meta-analyzed. Data were reported as weighted mean difference (MD) and 95% confidence interval (CI).
Ambulatory BP was excluded from the meta-analysis due to the limited number of studies (two studies). Comparing changes from pre- to post-intervention, no differences in resting systolic BP (MD - 0.22 mmHg [CI 95%, - 5.36 to 4.92], p = 0.93, I = 53%) and diastolic BP (MD - 0.38 mmHg [CI 95%, - 3.31 to 2.54], p = 0.74, I = 0%) were found between HIIT and MICT (seven studies; 164 participants). HIIT improved [Formula: see text]O to a greater magnitude than MICT (MD 2.13 ml/kg/min [CI 95%, 1.00 to 3.27], p < 0.01, I = 41%) with similar completion rates of the intervention and attendance at the exercise training sessions (nine studies; 245 participants). Limited data were available to compare the incidence of adverse events between HIIT and MICT.
HIIT and MICT provided comparable reductions in resting BP in adults with pre- to established hypertension. HIIT was associated with greater improvements in [Formula: see text]O when compared to MICT. Future randomized trials should investigate the efficacy of HIIT versus MICT for reducing ambulatory BP in adults with pre- to established hypertension.
PROSPERO registration (2016: CRD42016041885).
有氧运动可降低血压（BP），但高强度训练方法是否能在血压升高的人群中产生更大的降压效果尚不清楚。本系统评价比较了高强度间歇训练（HIIT）与中等强度持续训练（MICT）对高血压前期至确诊高血压成人血压降低的疗效。
检索了 5 个电子数据库（MEDLINE、EMBASE、CENTRAL、PEDro 和 SPORTDiscus），以比较 HIIT 与 MICT 在静息收缩压≥130mmHg 和/或舒张压≥85mmHg 和/或正在服用降压药物的个体中，慢性降压效果的随机试验。使用随机效应模型比较 HIIT 和 MICT 对静息和动态血压的干预前后变化。还对 HIIT 和 MICT 之间最大摄氧量（[Formula: see text]O）的干预前后变化进行了荟萃分析。数据以加权均数差值（MD）和 95%置信区间（CI）表示。
由于研究数量有限（两项研究），动态血压未纳入荟萃分析。比较干预前后的变化，HIIT 与 MICT 之间静息收缩压（MD -0.22mmHg [95%CI -5.36 至 4.92]，p=0.93，I=53%）和舒张压（MD -0.38mmHg [95%CI -3.31 至 2.54]，p=0.74，I=0%）无差异（七项研究；164 名参与者）。HIIT 改善[Formula: see text]O 的程度大于 MICT（MD 2.13ml/kg/min [95%CI 1.00 至 3.27]，p<0.01，I=41%），且干预完成率和运动训练课程出勤率相似（九项研究；245 名参与者）。可获得的有限数据无法比较 HIIT 与 MICT 之间不良事件的发生率。
HIIT 和 MICT 均可使高血压前期至确诊高血压成人的静息血压降低。与 MICT 相比，HIIT 与[Formula: see text]O 的改善相关。未来的随机试验应研究 HIIT 与 MICT 对降低高血压前期至确诊高血压成人的动态血压的疗效。
PROSPERO 注册（2016：CRD42016041885）。
