Morita Hidetaka, Abe Makiko, Suematsu Yasunori, Uehara Yoshinari, Koyoshi Rie, Fujimi Kanta, Ideishi Akihito, Takata Kohei, Kato Yuta, Hirata Tetsuo, Yahiro Eiji, Morito Natsumi, Kitajima Ken, 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 Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan.
Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Hypertens Res. 2025 Feb;48(2):733-743. doi: 10.1038/s41440-024-01998-9. Epub 2024 Nov 28.
Hypertension increases the risk of cerebrovascular disease and death. In addition to aerobic exercise, which is currently recommended for its antihypertensive effects, recent studies have suggested that dynamic and isometric resistance exercises also have antihypertensive effects. However, the magnitude of the antihypertensive effect of such resistance exercises is not well known. To clarify the differences in these effects, we conducted an umbrella review of a meta-analysis of randomized controlled trials (RCTs). A systematic search was performed on the Ovid MEDLINE and Cochrane Library, covering the period from inception to August 1, 2023. Eligible studies were RCTs comparing the effects of exercise and non-exercise on office, home, or ambulatory blood pressure (BP) in hypertensive patients aged 18 years or older. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. A sub-analysis determined outcomes by the type of exercise (aerobic exercise, dynamic resistance exercise, isometric resistance exercise, and combined exercise). Eighty-four RCTs with 5065 hypertensive patients were included in the study. All exercise significantly reduced systolic BP (SBP) and diastolic BP (DBP) compared to non-exercise (SBP:-7.52 mmHg, 95% confidence interval [CI] -8.77 to -6.27, p < 0.001; DBP: -4.36 mmHg, 95% CI - 5.15 to -3.57, p < 0.001). There were no significant differences in the magnitude of the reduction in BP between the types of exercise (p for interaction = 0.815 for SBP, p = 0.417 for DBP). These data from 84 RCTs showed that exercise intervention significantly reduced BP and that resistance exercise has a similar antihypertensive effect to aerobic exercise in hypertensive patients. This meta-analysis showed that exercise significantly reduced blood pressure in hypertensive patients. There were no significant differences in the magnitude of this reduction in BP between the types of exercise.
高血压会增加脑血管疾病和死亡的风险。除了目前因其降压作用而被推荐的有氧运动外，最近的研究表明，动态和等长抗阻运动也具有降压作用。然而，这种抗阻运动的降压效果大小尚不清楚。为了阐明这些效果的差异，我们对随机对照试验（RCT）的荟萃分析进行了一项汇总分析。在Ovid MEDLINE和Cochrane图书馆进行了系统检索，涵盖从创刊到2023年8月1日的时间段。符合条件的研究是比较运动和非运动对18岁及以上高血压患者诊室、家庭或动态血压（BP）影响的RCT。进行随机效应模型荟萃分析以估计多项研究的效应大小。一项亚分析根据运动类型（有氧运动、动态抗阻运动、等长抗阻运动和联合运动）确定结果。该研究纳入了84项涉及5065名高血压患者的RCT。与非运动相比，所有运动均显著降低收缩压（SBP）和舒张压（DBP）（SBP：-7.52 mmHg，95%置信区间[CI]-8.77至-6.27，p<0.001；DBP：-4.36 mmHg，95%CI -5.15至-3.57，p<0.001）。运动类型之间的血压降低幅度没有显著差异（SBP交互作用p=0.815，DBP p=0.417）。这84项RCT的数据表明，运动干预显著降低血压，并且抗阻运动在高血压患者中具有与有氧运动相似的降压效果。这项荟萃分析表明，运动显著降低了高血压患者的血压。运动类型之间的血压降低幅度没有显著差异。
