Williamson Wilby, Lewandowski Adam James, Huckstep Odaro John, Lapidaire Winok, Ooms Alexander, Tan Cheryl, Mohamed Afifah, Alsharqi Maryam, Bertagnolli Mariane, Woodward William, Dockerill Cameron, McCourt Annabelle, Kenworthy Yvonne, Burchert Holger, Doherty Aiden, Newton Julia, Hanssen Henner, Cruickshank John Kennedy, McManus Richard, Holmes Jane, Ji Chen, Love Sharon, Frangou Elena, Everett Colin, Hillsdon Melvyn, Dawes Helen, Foster Charlie, Leeson Paul
Radcliffe Department of Medicine, Oxford Cardiovascular Clinical Research Facility Division of Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK.
School of Medicine, Trinity College Dublin, Dublin, Ireland.
EClinicalMedicine. 2022 May 13;48:101445. doi: 10.1016/j.eclinm.2022.101445. eCollection 2022 Jun.
Exercise is advised for young adults with elevated blood pressure, but no trials have investigated efficacy at this age. We aimed to determine whether aerobic exercise, self-monitoring and motivational coaching lowers blood pressure in this group.
The study was a single-centre, open, two-arm, parallel superiority randomized clinical trial with open community-based recruitment of physically-inactive 18-35 year old adults with awake 24 h blood pressure 115/75mmHg-159/99 mmHg and BMI<35 kg/m. The study took place in the Cardiovascular Clinical Research Facility, John Radcliffe Hospital, Oxford, UK. Participants were randomized (1:1) with minimisation factors sex, age (<24, 24-29, 30-35 years) and gestational age at birth (<32, 32-37, >37 weeks) to the intervention group, who received 16-weeks aerobic exercise training (three aerobic training sessions per week of 60 min per session at 60-80% peak heart rate, physical activity self-monitoring with encouragement to do 10,000 steps per day and motivational coaching to maintain physical activity upon completion of the intervention. The control group were sign-posted to educational materials on hypertension and recommended lifestyle behaviours. Investigators performing statistical analyses were blinded to group allocation. The primary outcome was 24 h awake ambulatory blood pressure (systolic and diastolic) change from baseline to 16-weeks on an intention-to-treat basis. Clinicaltrials.gov registered on March 30, 2016 (NCT02723552).
Enrolment occurred between 30/06/2016-26/10/2018. Amongst the 203 randomized young adults ( = 102 in the intervention group; = 101 in the control group), 178 (88%; = 76 intervention group, = 84 control group) completed 16-week follow-up and 160 (79%; = 68 intervention group, = 69 control group) completed 52-weeks follow-up. There were no group differences in awake systolic (0·0 mmHg [95%CI, -2·9 to 2·8]; = 0·98) or awake diastolic ambulatory blood pressure (0·6 mmHg [95%CI, -1·4. to 2·6]; = 0·58). Aerobic training increased peak oxygen uptake (2·8 ml/kg/min [95%CI, 1·6 to 4·0]) and peak wattage (14·2watts [95%CI, 7·6 to 20·9]) at 16-weeks. There were no intervention effects at 52-weeks follow-up.
These results do not support the exclusive use of moderate to high intensity aerobic exercise training for blood pressure control in young adults.
Wellcome Trust, British Heart Foundation, National Institute for Health Research, Oxford Biomedical Research Centre.
建议血压升高的年轻人进行运动，但尚无试验研究该年龄段运动的效果。我们旨在确定有氧运动、自我监测和动机辅导是否能降低该人群的血压。
本研究为单中心、开放、双臂、平行优势随机临床试验，通过基于社区的方式公开招募身体不活跃的18至35岁成年人，其清醒24小时血压为115/75mmHg至159/99mmHg，且BMI<35kg/m²。研究在英国牛津约翰·拉德克利夫医院的心血管临床研究设施进行。参与者按1:1随机分组，随机化因素包括性别、年龄（<24岁、24 - 29岁、30 - 35岁）和出生孕周（<32周、32 - 37周、>37周），干预组接受16周的有氧运动训练（每周三次有氧运动，每次60分钟，心率达到峰值心率的60 - 80%），进行身体活动自我监测，并鼓励每天步行10000步，干预结束后提供动机辅导以维持身体活动。对照组则收到关于高血压和推荐生活方式行为的教育材料。进行统计分析的研究人员对分组情况不知情。主要结局指标是意向性分析中从基线到16周时24小时清醒动态血压（收缩压和舒张压）的变化。该研究于2016年3月30日在Clinicaltrials.gov注册（NCT02723552）。
2016年6月30日至2018年10月26日期间进行了入组。在203名随机分组的年轻人中（干预组102名；对照组101名）中有178名（88%；干预组76名，对照组84名）完成了16周的随访，160名（79%；干预组68名，对照组69名）完成了52周的随访。清醒收缩压（0.0mmHg [95%CI， - 2.9至2.8]；P = 0.98）或清醒舒张压动态血压（0.6mmHg [95%CI， - 1.4至2.6]；P = 0.58）在两组间无差异。16周时有氧运动训练使峰值摄氧量增加（2.8ml/kg/min [95%CI，1.6至4.0]），峰值功率增加（14.2瓦[95%CI，7.6至20.9]）。52周随访时无干预效果。
这些结果不支持单纯使用中高强度有氧运动训练来控制年轻人的血压。
惠康信托基金会、英国心脏基金会、国家卫生研究院、牛津生物医学研究中心。
