Park Seojin, Kim Jinhee, Lee Jina
J Cardiovasc Nurs. 2021 Jan/Feb;36(1):23-33. doi: 10.1097/JCN.0000000000000651.
The positive effect of exercise on blood pressure has been reported in studies that investigated mostly patients with hypertension but without diabetes mellitus. However, the effect of exercise in adults with both hypertension and type 2 diabetes mellitus (T2DM) is unclear, and no systematic review and meta-analysis has been conducted to clarify this effect.
This study was a systematic review and meta-analysis designed to investigate the effects of exercise on adults with both hypertension and T2DM.
Studies were selected using electronic databases. Data were extracted using a standardized protocol. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, a meta-analysis of the studies was conducted.
Of 3207 publications identified, 8 trials were used to estimate the effect size of exercise. Effect sizes (weighted mean difference [WMD]) were heterogeneous, and random-effects models were used. Exercise was effective for systolic blood pressure (WMD, -5.25 mm Hg; 95% confidence interval [CI], -8.39 to -2.12), diastolic blood pressure (WMD, -3.16 mm Hg; 95% CI, -4.91 to -1.40), body mass index (WMD, -1.47 kg/m; 95% CI, -2.39 to -0.55), and waist circumference (WMD, -2.91 cm; 95% CI, -5.68 to -0.15). In subgroup analyses, aerobic exercise seemed to be the most effective intervention for lowering systolic (WMD, -9.43 mm Hg; 95% CI, -13.63 to -5.23) and diastolic (WMD, -5.90 mm Hg; 95% CI, -7.69 to -4.11) blood pressure.
Exercise seemed effective in reducing systolic and diastolic blood pressure, with subgroup analyses indicating that this effect was most profound with aerobic exercise.
在大多针对高血压患者而非糖尿病患者的研究中,已报道了运动对血压的积极影响。然而,运动对同时患有高血压和2型糖尿病(T2DM)的成年人的影响尚不清楚,且尚未进行系统评价和荟萃分析来阐明这种影响。
本研究是一项系统评价和荟萃分析,旨在探讨运动对同时患有高血压和T2DM的成年人的影响。
使用电子数据库筛选研究。采用标准化方案提取数据。使用Cochrane协作网的工具评估偏倚风险。为估计效应量,对这些研究进行了荟萃分析。
在识别出的3207篇文献中,8项试验用于估计运动的效应量。效应量(加权均数差[WMD])存在异质性,故采用随机效应模型。运动对收缩压(WMD,-5.25 mmHg;95%置信区间[CI],-8.39至-2.12)、舒张压(WMD,-3.16 mmHg;95%CI,-4.91至-1.40)、体重指数(WMD,-1.47 kg/m²;95%CI,-2.39至-0.55)和腰围(WMD,-2.91 cm;95%CI,-5.68至-0.15)均有效果。在亚组分析中,有氧运动似乎是降低收缩压(WMD,-9.43 mmHg;95%CI,-13.63至-5.23)和舒张压(WMD,-5.90 mmHg;95%CI,-7.69至-4.11)最有效的干预措施。
运动似乎能有效降低收缩压和舒张压,亚组分析表明有氧运动的这种效果最为显著。