Department of Martial Arts, Wuhan Sports University, Wuhan, Hubei Province, China.
Department of Exercise Training, Wuhan Sports University, Wuhan, Hubei Province, China.
J Clin Hypertens (Greenwich). 2024 Jun;26(6):599-614. doi: 10.1111/jch.14818. Epub 2024 May 6.
Endothelial dysfunction is crucial factor to the hypertension occurrence, and controversy remains regarding the effect of exercise on improving endothelial function in hypertensive patients. The authors used meta-analysis to evaluate the intervention effect of exercise on endothelial function in hypertensive patients and to investigate exercise protocols that may have a greater intervention effect. A total of 37 studies and a total of 2801 participants were included. The results were as follows: endogenous nitric oxide (NO)[SMD = .89, 95% CI (.48, 1.30), p < .0001], endothelin-1 (ET-1): [SMD = -.94, 95% CI (-1.15, -.73), p <. 0001], flow-mediated dilation (FMD) [SMD = -.57, 95% CI (.36, .79), p < .000001]. In subgroup analysis, high-intensity aerobic exercise, with a single exercise duration of 35-50 min, 3-4 times/week for a total of 10-12 weeks, had the largest amount of intervention effect on NO, and moderate-intensity resistance exercise, with a single exercise duration of ≥60 min, 6 times/week for a total of 15-18 weeks, had the largest amount of intervention effect on ET-1. In conclusion, exercise can improve NO levels, FDM levels, and reduce ET-1 secretion of hypertension patients, thereby improve their endothelial function. The ideal intervention effect of improving NO level was more likely to be obtained by taking the exercise prescription of high-intensity aerobic exercise with a single exercise duration of 35-50 min, 3-4 times/week for 10-12 weeks; the ideal intervention effect of improving ET-1 was more likely to be obtained by taking the exercise prescription of oderate -intensity resistance exercise with a single exercise duration of ≥60 min, 6 times/week for 15-18 weeks.
内皮功能障碍是高血压发生的关键因素，关于运动对改善高血压患者内皮功能的影响仍存在争议。作者采用荟萃分析评估运动对高血压患者内皮功能的干预效果，并探讨可能具有更大干预效果的运动方案。共纳入 37 项研究，共计 2801 名参与者。结果如下：内源性一氧化氮（NO）[SMD = 0.89，95%CI（0.48，1.30），p < 0.0001]、内皮素-1（ET-1）：[SMD = -0.94，95%CI（-1.15，-0.73），p < 0.0001]、血流介导的舒张功能（FMD）[SMD = -0.57，95%CI（0.36，0.79），p < 0.000001]。亚组分析显示，高强度有氧运动，单次运动时长 35-50 分钟，每周 3-4 次，共 10-12 周，对 NO 的干预效果最大；中等强度抗阻运动，单次运动时长≥60 分钟，每周 6 次，共 15-18 周，对 ET-1 的干预效果最大。总之，运动可以改善高血压患者的 NO 水平、FDM 水平和降低 ET-1 分泌，从而改善内皮功能。改善 NO 水平的理想干预效果可能更容易通过采用单次运动时长 35-50 分钟、每周 3-4 次、共 10-12 周的高强度有氧运动运动方案来实现；改善 ET-1 的理想干预效果可能更容易通过采用单次运动时长≥60 分钟、每周 6 次、共 15-18 周的中等强度抗阻运动运动方案来实现。
