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家庭等长训练对血压处于正常高值或1级高血压的老年人血压的影响:一项随机对照试验。

Effect of home-based isometric training on blood pressure in older adults with high normal BP or stage I hypertension: A randomized controlled trial.

作者信息

Pinto Diogo, Dias Nuno, Garcia Catarina, Teixeira Manuel, Marques Maria J, Amaral Teresa, Amaral Leonor, Abreu Ricardo, Figueiredo Daniela, Polónia Jorge, Mesquita-Bastos José, Viana João L, Pescatello Linda S, Ribeiro Fernando, Alves Alberto J

机构信息

Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal.

Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal.

出版信息

J Am Geriatr Soc. 2025 Feb;73(2):574-582. doi: 10.1111/jgs.19213. Epub 2024 Oct 11.

Abstract

OBJECTIVE

This trial analyzes the effects of home-based isometric handgrip training (IHT) and aerobic exercise training (AET) on ambulatory and office blood pressure (BP) in older adults with high normal to established hypertension.

METHODS

This randomized controlled trial included 84 participants (46 women, 71.1 ± 3.6 years, systolic BP [SBP] 137.1 ± 13.8 mmHg, diastolic BP [DBP] 80.8 ± 8.3 mmHg). Participants were randomized into IHT (n = 28), AET (n = 28), or usual medical care plus lifestyle advice (UC, n = 28). Participants performed IHT or AET three times/week for 8 weeks. IHT consisted of 4 × 45 s bilateral contractions at 50% of maximum voluntary contraction with 1-min rest between sets. AET consisted of walking 30 min at 50%-70% of estimated maximum oxygen consumption. UC received standardized medical care including lifestyle advice.

RESULTS

Seventy-six participants completed the intervention: 27 in IHT, 26 in AET, and 23 in UC. At baseline, BP values were similar among groups. No differences were observed in 24-h ambulatory, daytime, and nighttime SBP and DBP in any group (p > 0.05). IHT and AET reduced office SBP (-8.0 ± 13.4 mmHg; p = 0.004; -5.6 ± 12.2 mmHg; p = 0.027, respectively). IHT reduced office DBP (-3.3 ± 7.4 mmHg; p = 0.024), but AET did not. No differences occurred in office BP in UC. There was no difference in office BP among groups (p > 0.05).

CONCLUSIONS

An 8-week home-based IHT and AET failed to reduce ambulatory SBP, while office SBP was reduced by 8/5 mmHg. Only IHT reduced office DBP by 3 mmHg. Thus, IHT and AET may be effective for lowering office BP in older adults with high normal to established hypertension.

摘要

目的

本试验分析居家等长握力训练(IHT)和有氧运动训练(AET)对血压处于正常高值至确诊高血压的老年人动态血压和诊室血压(BP)的影响。

方法

本随机对照试验纳入了84名参与者(46名女性,年龄71.1±3.6岁,收缩压[SBP]137.1±13.8mmHg,舒张压[DBP]80.8±8.3mmHg)。参与者被随机分为IHT组(n = 28)、AET组(n = 28)或常规医疗护理加生活方式建议组(UC组,n = 28)。参与者每周进行3次IHT或AET,共8周。IHT包括以最大自主收缩力的50%进行4组每组45秒的双侧收缩,组间休息1分钟。AET包括以估计最大耗氧量的50%-70%步行30分钟。UC组接受包括生活方式建议在内的标准化医疗护理。

结果

76名参与者完成了干预:IHT组27人,AET组26人,UC组23人。在基线时,各组间血压值相似。任何组的24小时动态血压、日间和夜间SBP及DBP均未观察到差异(p>0.05)。IHT和AET均降低了诊室SBP(分别为-8.0±13.4mmHg;p = 0.004;-5.6±12.2mmHg;p = 0.)。IHT降低了诊室DBP(-3.3±7.4mmHg;p = 0.024),但AET未降低。UC组的诊室血压无差异。各组间诊室血压无差异(p>0.05)。

结论

为期8周的居家IHT和AET未能降低动态SBP,而诊室SBP降低了8/5mmHg。只有IHT使诊室DBP降低了3mmHg。因此,IHT和AET可能对降低血压处于正常高值至确诊高血压的老年人的诊室血压有效。

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