运动干预对中老年亚裔人群高血压防治效果评价的Meta分析

Effect of exercise on prehypertension and hypertension in middle-aged and elderly people in Asian populations:a meta-analysis

目的系统评价运动对中老年亚裔人群高血压前期个体和高血压患者血压的影响,为制定精准的运动处方提供依据。方法采用PubMed、EMBASE、the Cochrane Library、Web of Science、中国知网、万方数据库,收集运动对中老年高血压前期个体和高血压患者血压影响的随机对照试验,应用Cochrane风险偏倚评估工具进行质量评价,Stata 15.0软件进行Meta分析。结果共纳入23篇文献,2095例研究对象。Meta分析结果显示,与对照组相比,有氧运动(WMD=-9.94,95%CI=-12.59~-7.29,P<0.001)、抗阻运动(WMD=-11.15,95%CI=-18.36~-3.95,P=0.002)、有氧联合抗阻运动(WMD=-6.09,95%CI=-8.87~-3.31,P=0.005)均可降低收缩压水平;有氧运动(WMD=-6.46,95%CI=-8.20~-4.72,P<0.001)和抗阻运动(WMD=-4.38,95%CI=-8.07~-0.69,P=0.02)可降低舒张压水平,而有氧联合抗阻运动(WMD=-4.88,95%CI=-12.87~3.11,P=0.232)对舒张压的影响差异无统计学意义。亚组分析结果提示,年龄、基线血压、运动强度、运动时间、运动频率和运动周期的不同是异质性的主要来源;漏斗图和Egger's检验表明本次发表偏倚差异无统计学意义(P>0.05)。结论有氧运动和抗阻运动对于降低中老年亚裔人群高血压前期和高血压患者的血压均有较好效果。

Objective To systematically evaluate the effect of exercise on blood pressure of middle-aged and elderly Asian populations with prehypertension and hypertension,and to provide theoretical basis for formulating accurate exercise prescriptions.Methods Randomized controlled trials on the effect of exercise on blood pressure in middle-aged and elderly patients with prehypertension and hypertension were collected by PubMed,EMBASE,the Cochrane Library,Web of Science,CNKI and Wanfang Database.The quality of the included studies was evaluated by the Cochrane risk bias assessment tool,and the meta-analysis was performed with Stata 15.0 software.Results A total of 23 articles and 2095 subjects were included.Meta analysis showed that compared with the control group,aerobic exercise(WMD=-9.94,95%CI=-12.59--7.29,P<0.001),resistance exercise(WMD=-11.15,95%CI=-18.36--3.95,P=0.002)and aerobic combined resistance exercise(WMD=-6.09,95%CI=-8.87--3.31,P=0.005)could reduce the systolic blood pressure level.Aerobic exercise(WMD=-6.46,95%CI=-8.20--4.72,P<0.001)and resistance exercise(WMD=-4.38,95%CI=-8.07--0.69,P=0.02)could reduce the level of diastolic blood pressure,while aerobic combined resistance exercise(WMD=-4.88,95%CI=-12.87-3.11,P=0.232)had no significant effect on diastolic blood pressure.The results of subgroup analysis indicated that the differences of age,baseline blood pressure,exercise intensity,exercise time,exercise frequency,and motion cycle were the main sources of heterogeneity.The funnel plot and Egger's test indicated that there was no publication bias in this Meta-analysis.Conclusion Aerobic exercise and resistance exercise both have positive effects on reducing blood pressure of middle-aged and elderly Asian populations with prehypertension and hypertension.