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药物治疗的高血压患者对握力训练反应性相关特征:二次数据分析。

Characteristics associated with responsiveness to isometric handgrip training in medicated hypertensive patients: secondary data analysis.

机构信息

Graduate Program in Physical Education, Universidade Federal Rural de Pernambuco, Recife.

Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho.

出版信息

J Hypertens. 2024 Aug 1;42(8):1421-1426. doi: 10.1097/HJH.0000000000003749. Epub 2024 Apr 22.

Abstract

OBJECTIVE

Isometric handgrip training (IHT) has been shown to reduce blood pressure (BP) in hypertensive patients. However, factors that predict responsiveness to IHT are largely unknown. The aim of this study was to investigate the patient characteristics associated with the antihypertensive response to IHT using a recommended statistical approach for evaluating interindividual responses.

METHODS

Data from four randomized controlled trials were combined, totaling 81 patients undergoing IHT (48.8% women; 60 ± 11 years) and 90 control patients (45.6% women; 62 ± 12 years). IHT consisted of 4 × 2 min isometric contractions at 30% of maximal voluntary contraction, performed three times/week for 8-12 weeks. BP was measured at baseline and following IHT and control interventions. The interindividual variation was assessed by the standard deviation of the individual responses (SD ir ), and linear regression analyses were conducted to explore response predictors.

RESULTS

IHT significantly decreased both SBP (-5.4; 95% confidence interval (CI) -9.5 to -1.3 mmHg) and DBP (-2.8; 95% CI -5.1 to -0.6 mmHg). The interindividual variation of BP change was moderate for systolic (SD ir  = 5.2 mmHg, 0.30 standardized units) and low for diastolic (SD ir  = 1.7 mmHg, 0.15 standardized units). Sex, age, and BMI were not associated with the antihypertensive effect of IHT. However, a higher baseline SBP ( b  = -0.467, P  < 0.001) and absence of dihydropyridine calcium channel blockers use ( b  = 0.340, P  = 0.001) were associated with greater BP reductions.

CONCLUSION

IHT reduced BP in medicated hypertensive patients regardless of age, sex, and BMI. Patients with a higher baseline SBP and those not prescribed dihydropyridine calcium channel blockers were more responsive to IHT.

摘要

目的

等长握力训练(IHT)已被证明可降低高血压患者的血压(BP)。然而,预测对 IHT 反应的因素在很大程度上尚不清楚。本研究旨在使用评估个体间反应的推荐统计方法,研究与 IHT 降压反应相关的患者特征。

方法

合并了四项随机对照试验的数据,共纳入 81 例接受 IHT 的高血压患者(48.8%女性;60±11 岁)和 90 例对照患者(45.6%女性;62±12 岁)。IHT 包括 30%最大自主收缩的 4×2 分钟等长收缩,每周 3 次,持续 8-12 周。在基线和 IHT 及对照干预后测量血压。个体间变异通过个体反应的标准差(SD ir)进行评估,并进行线性回归分析以探讨反应预测因素。

结果

IHT 显著降低了收缩压(-5.4;95%置信区间(CI)-9.5 至-1.3mmHg)和舒张压(-2.8;95% CI-5.1 至-0.6mmHg)。血压变化的个体间变异在收缩压方面中等(SD ir=5.2mmHg,0.30 标准化单位),在舒张压方面较低(SD ir=1.7mmHg,0.15 标准化单位)。性别、年龄和 BMI 与 IHT 的降压效果无关。然而,较高的基线收缩压( b=-0.467,P<0.001)和不使用二氢吡啶钙通道阻滞剂( b=0.340,P=0.001)与血压降低幅度更大相关。

结论

IHT 降低了接受药物治疗的高血压患者的血压,无论年龄、性别和 BMI 如何。基线收缩压较高和未开二氢吡啶钙通道阻滞剂的患者对 IHT 的反应更好。

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