Zhang Bingxue, Hu Hongjuan, Mi Ziyi, Liu Haidi
School of Nursing, University of South China, Hengyang, Hunan, 421000, People's Republic of China.
Department of Public Health Service, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
Int J Gen Med. 2025 Jun 3;18:2823-2838. doi: 10.2147/IJGM.S516371. eCollection 2025.
This study was based on the PICO framework to systematically evaluate the effects of aerobic exercise on key health management indicators such as blood pressure, heart rate and cardiorespiratory fitness in older hypertensive patients.
A systematic search of randomized controlled trials from four English language databases, Web of Science, PubMed, Cochrane, and Embase, and four Chinese language databases, CNKI, VIP, Wanfang, and Sinomed, was performed (April 2014 to April 2024). StataCorp Stata v.18.0 was used for data analysis. In a random-effects meta-analysis, continuous variables were represented by the mean difference, and each effect size was represented by a 95% confidence interval.
Nine randomized controlled trials with 484 participants were included. The meta-analysis revealed that compared with the control group, participants engaging in aerobic exercise significantly reduced systolic blood pressure (SMD = -0.93, 95% CI = -1.48 to -0.39, =0.001), diastolic blood pressure (SMD = -0.48, 95% CI = -0.75 to -0.21, =0.001), and heart rate (SMD = -1.78, 95% CI = -3.31 to -0.24, =0.024), and improved cardiorespiratory health (SMD =0.71, 95% CI =0.24 to 1.18, =0.003).
Older patients with hypertension aged 60 years should engage in 120-150 minutes of low- to moderate-intensity aerobic exercise per week, maintaining 40-75% maximum HR or 40-60% VOmax (20-30 minutes per day, 5 days per week, or 75-150 minutes of exercise only once or twice a week. However, it is crucial that individuals assess their own health conditions, make appropriate time adjustments, and gradually increase the duration and intensity of exercise. And central randomization with blinded assessment should be used in future randomized controlled trials to reduce implementation bias and measurement bias.
本研究基于PICO框架，系统评价有氧运动对老年高血压患者血压、心率和心肺适能等关键健康管理指标的影响。
对四个英文数据库（科学网、PubMed、Cochrane和Embase）以及四个中文数据库（中国知网、维普、万方和中国生物医学文献数据库）进行系统检索（2014年4月至2024年4月）。使用StataCorp Stata v.18.0进行数据分析。在随机效应荟萃分析中，连续变量用平均差表示，每个效应量用95%置信区间表示。
纳入9项随机对照试验，共484名参与者。荟萃分析显示，与对照组相比，进行有氧运动的参与者显著降低了收缩压（标准化均数差=-0.93，95%置信区间=-1.48至-0.39，P=0.001）、舒张压（标准化均数差=-0.48，95%置信区间=-0.75至-0.21，P=0.001）和心率（标准化均数差=-1.78，95%置信区间=-3.31至-0.24，P=0.024），并改善了心肺健康（标准化均数差=0.71，95%置信区间=0.24至1.18，P=0.003）。
60岁的老年高血压患者每周应进行120-150分钟的低至中等强度有氧运动，保持最大心率的40-75%或最大摄氧量的40-60%（每天20-30分钟，每周5天，或每周仅进行1-2次75-150分钟的运动）。然而，个人评估自身健康状况、进行适当的时间调整并逐渐增加运动时长和强度至关重要。未来的随机对照试验应采用中心随机化和盲法评估，以减少实施偏倚和测量偏倚。
