Suematsu Yasunori, Morita Hidetaka, Abe Makiko, Uehara Yoshinari, Koyoshi Rie, Fujimi Kanta, Ideishi Akihito, Takata Kohei, Kato Yuta, Hirata Tetsuo, Yahiro Eiji, Morito Natsumi, Kitajima Ken, Yano Yuiko, Satoh Atsushi, Yoshimura Chikara, Ishida Shintaro, Okutsu Shota, Takahashi Koji, Shinohara Yukiko, Sakaguchi Takashi, Katsuki Shiori, Tada Kazuhiro, Fujii Takako, Funakoshi Shunsuke, Hu Yaopeng, Satoh Tomonori, Ohnishi Hirofumi, Okamura Keisuke, Mizuno Hiroyuki, Arakawa Kimika, Asayama Kei, Ohtsubo Toshio, Ishigami Tomoaki, Shibata Shigeru, Fujita Takayuki, Munakata Masanori, Ohishi Mitsuru, Ichihara Atsuhiro, Katsuya Tomohiro, Mukoyama Masashi, Rakugi Hiromi, Node Koichi, Arima Hisatomi, Miura Shin-Ichiro
Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan.
Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan.
Hypertens Res. 2025 Feb;48(2):720-732. doi: 10.1038/s41440-024-01974-3. Epub 2024 Nov 1.
Although hypertension is a major cause of cardiovascular disease, the control of blood pressure (BP) is insufficient worldwide. Exercise is an effective treatment for reducing BP, but the differences in the blood pressure lowering effects of exercise according to the underlying pathophysiological condition, the type of exercise, and the geographic region are not fully understood. An umbrella review with a meta-analysis of 435 randomized controlled trials that investigated the BP-lowering effects of exercise was performed using Ovid MEDLINE and the Cochrane Library, covering the period from inception to August 1, 2023. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. Exercise significantly reduced systolic BP in healthy subjects (-3.51 mmHg, 95% confidence interval: -3.90, -3.11; p < 0.001) and in those with lifestyle-related diseases including hypertension (-5.48 mmHg, -6.51, -4.45; p < 0.001), but not in those with cardiovascular diseases (-1.16 mmHg, -4.08, 1.76; p = 0.44). According to the type of exercise, all types significantly reduced systolic BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases. According to the region, in Oceania, there were no reductions in systolic BP. In Asia, systolic BP was reduced in patients with cardiovascular diseases. In conclusion, any type of exercise reduced BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases, and the region affected the effect of exercise. When using exercise to reduce hypertension, it is important to consider the patient's pathophysiological condition and the region.
尽管高血压是心血管疾病的主要病因，但全球范围内血压（BP）控制仍不充分。运动是降低血压的有效治疗方法，但运动降压效果因潜在病理生理状况、运动类型和地理区域的差异尚未完全明确。利用Ovid MEDLINE和Cochrane图书馆进行了一项伞状综述，并对435项研究运动降压效果的随机对照试验进行荟萃分析，涵盖从起始至2023年8月1日的时间段。采用随机效应模型荟萃分析来估计多项研究的效应量。运动显著降低了健康受试者的收缩压（-3.51mmHg，95%置信区间：-3.90，-3.11；p<0.001）以及患有包括高血压在内的生活方式相关疾病的受试者的收缩压（-5.48mmHg，-6.51，-4.45；p<0.001），但未降低心血管疾病患者的收缩压（-1.16mmHg，-4.08，1.76；p=0.44）。根据运动类型，所有类型的运动均显著降低了健康受试者和患有生活方式相关疾病的受试者的收缩压，但未降低心血管疾病患者的收缩压。根据地区来看，在大洋洲，收缩压没有降低。在亚洲，心血管疾病患者的收缩压有所降低。总之，任何类型的运动都能降低健康受试者和患有生活方式相关疾病的受试者的血压，但不能降低心血管疾病患者的血压，且地区会影响运动效果。在利用运动降低高血压时，考虑患者的病理生理状况和地区很重要。
