摘要
目的:血压升高会加剧罹患心血管疾病的风险。等长运动训练能显著降低静息血压,但影响其效果的因素不明确,目前也尚未得出具体的应用建议。文章旨在通过荟萃分析评估等长运动训练对静息血压的影响,探究调节因素,并基于其剂量-效应关系提出循证建议。方法:基于PRISMA声明,文章以“Isometric exercise training”“Systolic blood pressure”“Diastolic blood pressure”等为检索词,系统检索Pub Med、Embase、Cochrane Library、Scopus和Web of Science数据库,检索时限为各数据库建库至2024年9月。纳入有关等长运动训练与静息血压的随机对照试验,由3名独立研究者对文献进行筛选与数据提取,使用Risk of Bias 2.0工具和GRADE框架评估偏倚风险和质量等级,应用R语言(版本4.3.4)完成主效应合并、发表偏倚评价、亚组与回归分析。结果:纳入28篇文献,共32项随机对照试验,涉及977名受试者。(1)荟萃分析结果显示,相较于无运动,等长运动训练能显著降低静息收缩压(MD=-8.01,95%CI:-9.22至-6.80,P <0.01,I2=18.20%,低证据等级)和舒张压(MD=-3.46,95%CI:-4.64至-2.28,P <0.01,I2=0%,中等证据等级)。(2)亚组分析结果显示,性别、健康状况、运动方式、运动频率、运动强度、运动周期、每节训练次数、每节训练间歇时长和基线血压水平均能对收缩压(亚组间P <0.01)和舒张压(亚组间P <0.05)的主效应合并有显著的影响。(3)回归分析结果显示,未观察到任何显著的影响因素,但体质量指数(β=-4.11,P=0.091)对收缩压的主效应合并有显著的负向趋势。(4)上述Meta分析结果未发现显著的发表偏倚(P> 0.05)。结论:(1)等长运动训练能显著降低收缩压(低证据等级)与舒张压(中等证据等级),且降低阈值具有临床意义。(2)参与者特征(性别、健康状况、基线血压水平和体质量指数)以及等长运动训练方案(方式、频率、强度、时长、周期、每节训练次数和每节训练间歇时长)均会影响等长运动训练对静息血压的降压作用。(3)文章推荐最佳血压管理等长训练运动处方为:每周3次训练,每次4组运动,每组持续收缩2 min、间歇休息2 min,运动强度为95%HRpeak的等长壁蹲训练;可以6周的干预时间为节点,按需调整干预周期。未来亟待更多高质量研究以进一步验证和支持以上结论。
OBJECTIVE:Elevated blood pressure increases the risk of cardiovascular diseases.Isometric exercise training has been shown to significantly reduce resting blood pressure,but the factors influencing its effectiveness remain unclear,and specific application guidelines are yet to be established.This study aims to evaluate the impact of isometric exercise training on resting blood pressure through meta-analysis,explore its moderating factors,and provide evidence-based recommendations based on its dose-response relationship.METHODS:Following the PRISMA guidelines,a systematic search was conducted in PubMed,Embase,Cochrane Library,Scopus,and Web of Science databases using keywords“Isometric exercise training,”“Systolic blood pressure,”and“Diastolic blood pressure,”covering literature up to September 2024.Randomized controlled trials involving isometric exercise training and resting blood pressure were included.Three independent researchers performed literature screening and data extraction,assessing bias risk and quality grades using the Risk of Bias 2.0 tool and GRADE framework.Main effect pooling,publication bias assessment,subgroup,and regression analysis were conducted using R software(version 4.3.4).RESULTS:A total of 28 articles(comprising 32 randomized controlled trials)involving 977 participants were included.(1)Meta-analysis results indicated that isometric exercise training significantly reduced resting systolic blood pressure(MD=-8.01,95%CI=-9.22 to-6.80,P<0.01,I²=18.20%,low evidence grade)and diastolic blood pressure(MD=-3.46,95%CI=-4.64 to-2.28,P<0.01,I²=0%,moderate evidence grade)compared to no exercise.(2)Subgroup analysis results revealed significant influences of gender,health status,exercise modality,frequency,intensity,duration,sets per session,rest duration,and baseline blood pressure on the main effects for both systolic(P<0.01)and diastolic blood pressure(P<0.05).(3)Regression analysis results did not show any significant influencing factors,but body mass index(β=-4.11,P=0.091)showed a significant negative trend on the main effect for systolic blood pressure.(4)No significant publication bias was observed in the meta-analysis results(P>0.05).CONCLUSION:(1)Isometric exercise training significantly lowers systolic(low evidence grade)and diastolic(moderate evidence grade)blood pressure with clinically meaningful thresholds.(2)Participant characteristics(gender,health status,baseline blood pressure,and body mass index)and isometric exercise training protocols(modality,frequency,intensity,duration,cycle,sets per session,and rest duration)influence its antihypertensive effects.(3)The article recommends the optimal blood pressure management prescription:three sessions per week,with four sets per session,each set lasting 2 minutes with a 2-minute rest,at an intensity of 95%HRpeak using isometric wall squat exercises;the intervention period can be adjusted around a 6-week node.Future high-quality research is urgently needed to further validate and support these conclusions.
作者
蒋阳
彭皓
宋艳萍
姚娜
宋粤渝
尹兴晓
李艳琪
陈奇刚
Jiang Yang;Peng Hao;Song Yanping;Yao Na;Song Yueyu;Yin Xingxiao;Li Yanqi;Chen Qigang(School of Physical Education,Yunnan Normal University,Kunming 650500,Yunnan Province,China;Department of Rehabilitation Medicine,Third Affiliated Hospital of Yunnan University of Chinese Medicine(Kunming Municipal Hospital of Traditional Chinese Medicine),Kunming 650011,Yunnan Province,China)
出处
《中国组织工程研究》
北大核心
2026年第4期975-986,共12页
Chinese Journal of Tissue Engineering Research
基金
云南省科技计划项目(202201AH070001-060),项目负责人:陈奇刚
云南省中医联合专项青年项目(202301AZ070001-154),项目负责人:姚娜。
关键词
运动处方
等长运动训练
等长运动
血压管理
高血压
静息血压
META分析
exercise prescription
isometric exercise training
isometric exercise
blood pressure management
hypertension
resting blood pressure
metaanalysis
