Baffour-Awuah Biggie, Dieberg Gudrun, Pearson Melissa J, Smart Neil A
Clinical Exercise Physiology, School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia.
Biomedical Sciences, School of Science and Technology, Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia.
Int J Cardiol Hypertens. 2021 Feb 23;8:100081. doi: 10.1016/j.ijchy.2021.100081. eCollection 2021 Mar.
Previous work has evaluated the effect of remote ischaemic conditioning (RIC) in a number of clinical conditions (e.g. cardiac surgery and acute kidney injury), but only one analysis has examined blood pressure (BP) changes. While individual studies have reported the effects of acute bouts and repeated RIC exposure on resting BP, efficacy is equivocal. We conducted a systematic review and meta-analysis to evaluate the effects of acute and repeat RIC on BP.
A systematic search was performed using PubMed, Web of Science, EMBASE, and Cochrane Library of Controlled Trials up until October 31, 2020. Additionally, manual searches of reference lists were performed. Studies that compared BP responses after exposing participants to either an acute bout or repeated cycles of RIC with a minimum one-week intervention period were considered.
Eighteen studies were included in this systematic review, ten examined acute effects while eight investigated repeat effects of RIC. Mean differences (MD) for outcome measures from acute RIC studies were: systolic BP 0.18 mmHg (95%CI -0.95, 1.31; = 0.76), diastolic BP -0.43 mmHg (95%CI -2.36, 1.50; = 0.66), MAP -1.73 mmHg (95%CI -3.11, -0.34; = 0.01) and HR -1.15 bpm (95%CI -2.92, 0.62; = 0.20). Only MAP was significantly reduced. Repeat RIC exposure showed non-significant change in systolic BP -3.23 mmHg (95%CI -6.57, 0.11; = 0.06) and HR -0.16 bpm (95%CI -7.08, 6.77; = 0.96) while diastolic BP -2.94 mmHg (95%CI -4.08, -1.79; < 0.00001) and MAP -3.21 mmHg (95%CI -4.82, -1.61; < 0.0001) were significantly reduced.
Our data suggests repeated, but not acute, RIC produced clinically meaningful reductions in diastolic BP and MAP.
先前的研究评估了远程缺血预处理（RIC）在多种临床情况下（如心脏手术和急性肾损伤）的效果，但仅有一项分析研究了血压（BP）变化。虽然个别研究报告了急性发作和重复RIC暴露对静息血压的影响，但其疗效并不明确。我们进行了一项系统评价和荟萃分析，以评估急性和重复RIC对血压的影响。
截至2020年10月31日，使用PubMed、科学网、EMBASE和Cochrane对照试验图书馆进行系统检索。此外，还对手动检索参考文献列表。纳入了比较参与者接受急性发作或重复周期的RIC暴露（干预期至少为一周）后的血压反应的研究。
本系统评价纳入了18项研究，其中10项研究了急性效应，8项研究了RIC的重复效应。急性RIC研究中结局指标的平均差值（MD）为：收缩压0.18 mmHg（95%CI -0.95，1.31；P = 0.76），舒张压-0.43 mmHg（95%CI -2.36，1.50；P = 0.66），平均动脉压-1.73 mmHg（95%CI -3.11，-0.34；P = 0.01）和心率-1.15次/分钟（95%CI -2.92，0.62；P = 0.20）。只有平均动脉压显著降低。重复RIC暴露显示收缩压-3.23 mmHg（95%CI -6.57，0.11；P = 0.06）和心率-0.16次/分钟（95%CI -7.08，6.77；P = 0.96）无显著变化，而舒张压-2.94 mmHg（95%CI -4.08，-1.79；P < 0.00001）和平均动脉压-3.21 mmHg（95%CI -4.82，-1.61；P < 0.0001）显著降低。
我们的数据表明重复而非急性RIC可使舒张压和平均动脉压产生具有临床意义的降低。
