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.
Hypertens Res. 2022 Mar;45(3):483-495. doi: 10.1038/s41440-021-00839-3. Epub 2022 Jan 12.
Uncontrolled hypertension remains the major risk factor for cardiovascular disease. Isometric resistance training (IRT) has been shown to be a useful nonpharmacological therapy for reducing blood pressure (BP); however, some exercise physiologists and other health professionals are uncertain of the efficacy and safety of IRT. Experts' consensus was sought in light of the current variability of IRT use as an adjunct treatment for hypertension. An expert consensus-building analysis (Delphi study) was conducted on items relevant to the safety, efficacy and delivery of IRT. The study consisted of 3 phases: (1) identification of items and expert participants for inclusion; (2) a two-round modified Delphi exercise involving expert panelists to build consensus; and (3) a study team consensus meeting for a final item review. A list of 50 items was generated, and 42 international experts were invited to join the Delphi panel. Thirteen and 10 experts completed Delphi Rounds 1 and 2, respectively, reaching consensus on 26 items in Round 1 and 10 items in Round 2. The study team consensus meeting conducted a final item review and considered the remaining 14 items for the content list. A final list of 43 items regarding IRT reached expert consensus: 7/10 items on safety, 11/11 items on efficacy, 10/12 items on programming, 8/10 items on delivery, and 7/7 on the mechanism of action. This study highlights that while experts reached a consensus that IRT is efficacious as an antihypertensive therapy, some still have safety concerns, and there is also ongoing conjecture regarding optimal delivery.
未控制的高血压仍然是心血管疾病的主要危险因素。等长抗阻训练（IRT）已被证明是一种有用的非药物治疗方法，可降低血压（BP）；然而，一些运动生理学家和其他健康专业人员对 IRT 的疗效和安全性存在疑问。鉴于目前 IRT 作为高血压辅助治疗的应用存在差异，专家们寻求达成共识。对与 IRT 的安全性、疗效和实施相关的项目进行了专家共识建立分析（德尔菲研究）。该研究包括 3 个阶段：（1）确定纳入的项目和专家参与者；（2）两轮修改后的德尔菲研究，涉及专家组，以达成共识；（3）研究团队共识会议，对最终项目进行审查。生成了一份 50 项的清单，并邀请了 42 名国际专家加入德尔菲小组。13 名和 10 名专家分别完成了德尔菲研究的第 1 轮和第 2 轮，在第 1 轮中就 26 项达成共识，在第 2 轮中就 10 项达成共识。研究团队共识会议对最后一轮项目进行了审查，并考虑了内容清单中剩余的 14 项。关于 IRT 的专家共识最终达成了 43 项项目：安全性方面的 7/10 项、疗效方面的 11/11 项、编程方面的 10/12 项、实施方面的 8/10 项以及作用机制方面的 7/7 项。本研究表明，尽管专家们一致认为 IRT 作为一种抗高血压治疗方法是有效的，但一些专家仍然对其安全性存在担忧，而且对于最佳实施方式也存在持续的猜测。
