Cui Wenlai, Xie Jun
Graduate School, Capital University of Physical Education and Sports, Beijing, China.
PLOS Glob Public Health. 2024 Dec 16;4(12):e0003743. doi: 10.1371/journal.pgph.0003743. eCollection 2024.
Numerous studies have demonstrated the positive effects of exercise as a non-pharmacological treatment for hypertensive patients. However, there was a relative lack of research analyzing the effects of different exercise doses on hypertensive individuals. Therefore, the primary objective of this study was to evaluate the impact of different exercise doses on blood pressure (BP) and heart rate (HR) in hypertensive patients through a systematic review and meta-analysis. A systematic search was conducted across four electronic databases (PubMed, Embase, Web of Science, and Cochrane), focusing on the impact of exercise on BP and HR in hypertensive patients, followed by literature screening. Based on the American College of Sports Medicine (ACSM) recommendations for aerobic, resistance, and flexibility exercises in hypertensive patients, the intervention measures from 29 randomized controlled trials were evaluated and categorized as high adherence and low/uncertainty adherence groups according to ACSM recommendations. Differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR between ACSM high and low/uncertainty adherence exercises were reported and evaluated using standardized mean difference (SMD) and 95% confidence interval (95% CI). A total of 25 articles were included, comprising 29 studies, with 16 studies categorized as high adherence with ACSM recommendations and 13 categorized as low or uncertain adherence. For the three outcome measures, the SMD ratio of exercise interventions with high ACSM adherence to those with low or uncertain ACSM adherence was as follows: systolic blood pressure (- 1.20: - 0.75), diastolic blood pressure (- 0.84: - 0.78), and heart rate (- 0.37: - 0.40). The results suggest that exercise interventions with high adherence to ACSM recommendations had a more significant impact on SBP and DBP in hypertensive patients, while the impact on HR was less pronounced than that of interventions with low or uncertain adherence to ACSM recommendations. This systematic review and meta-analysis was registered in PROSPERO (CRD 42023460293).
众多研究已证明运动作为高血压患者的非药物治疗方法具有积极作用。然而，相对缺乏分析不同运动剂量对高血压个体影响的研究。因此，本研究的主要目的是通过系统评价和荟萃分析来评估不同运动剂量对高血压患者血压（BP）和心率（HR）的影响。在四个电子数据库（PubMed、Embase、Web of Science和Cochrane）中进行了系统检索，重点关注运动对高血压患者血压和心率的影响，随后进行文献筛选。根据美国运动医学学院（ACSM）对高血压患者有氧运动、抗阻运动和柔韧性运动的建议，对29项随机对照试验的干预措施进行了评估，并根据ACSM建议分为高依从性组和低/不确定依从性组。报告并使用标准化均数差（SMD）和95%置信区间（95%CI）评估了ACSM高依从性运动与低/不确定依从性运动之间收缩压（SBP）、舒张压（DBP）和心率的差异。共纳入25篇文章，包括29项研究，其中16项研究被归类为符合ACSM建议的高依从性研究，13项被归类为低依从性或不确定依从性研究。对于三项结局指标，ACSM高依从性运动干预与低或不确定依从性运动干预的SMD比值如下：收缩压（-1.20：-0.75）、舒张压（-0.84：-0.78）和心率（-0.37：-0.40）。结果表明，高度符合ACSM建议的运动干预对高血压患者的收缩压和舒张压有更显著的影响，而对心率的影响不如低依从性或不确定依从性的ACSM建议干预明显。本系统评价和荟萃分析已在PROSPERO（CRD 42023460293）注册。
