高强度间歇训练对高血压患者干预效果的Meta分析
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摘要
目的评价高强度间歇训练(HIIT)对高血压患者的干预效果。方法计算机检索PubMed、Web of Science、The Cochrane Library、EBSCO、万方数据知识服务平台、中国知网及维普网等数据库,检索时间为建库至2018年8月,筛选检索有关HIIT对高血压患者干预效果的随机对照试验。在药物治疗基础上,对照组患者进行常规活动或中等强度运动,试验组患者进行HIIT。比较两组患者干预后收缩压、舒张压、最大摄氧量(VO_2max)、静息心率、体质指数(BMI)。采用RevMan 5.3软件进行Meta分析。结果最终纳入6篇文献,其中英文文献5篇、中文文献1篇,共包括253例患者。Meta分析结果显示,试验组患者干预后收缩压〔加权均数差(WMD)=-4.58,95%CI(-7.51,-1.65)〕、舒张压〔WMD=-2.15,95%CI(-3.98,-0.32)〕、静息心率〔WMD=-3.24,95%CI(-5.82,-0.65)〕低于对照组(P<0.05),VO_2max高于对照组〔WMD=3.24,95%CI(1.23,5.25),P<0.05〕;两组患者干预后BMI比较,差异无统计学意义〔WMD=-0.54,95%CI(-1.87,0.78),P>0.05〕。6篇文献均未报道明显不良事件。纳入文献数量较少,无法分析发表偏倚,故不能排除发表偏倚的可能。结论现有文献证据表明,HIIT能有效提高1～2级或药物控制良好的高血压患者降压效果及VO_2max,减慢静息心率,增加心肺耐力,但对BMI无明显影响。
Objective To evaluate the intervention effect of high intensity interval training(HIIT)on hypertension patients. Methods Computer was used to research databases including PubMed,Web of Science,The Cochrane Library,EBSCO,Wanfang Data,CNKI and VIP from establishment to August 2018,to screen randomized controlled trial about intervention effect of HIIT on hypertension patients. Based on drug therapy,patients in control group received regular activity or moderate intensity exercises,while patients in test group received HIIT. SBP,DBP,VO_2 max,resting heart rate and BMI were compared between the two groups after intervention. RevMan 5.3 software was used to complete the Meta-analysis. Results A total of 6 literatures were enrolled(including 253 patients),thereinto 5 literatures were English,1 literature was Chinese.Meta-analysis results showed that,SBP〔WMD=-4.58,95%CI(-7.51,-1.65)〕,DBP〔WMD=-2.15,95%CI(-3.98,-0.32)〕and resting heart rate〔WMD=-3.24,95%CI(-5.82,-0.65)〕in observation group were statistically significantly lower than those in control group after intervention(P<0.05),while VO_2 max in observation group was statistically significantly higher than that in control group after intervention〔WMD=3.24,95%CI(1.23,5.25),P<0.05〕;no statistically significant difference of BMI was found between the two groups after intervention〔WMD=-0.54,95%CI(-1.87,0.78),P>0.05〕.No adverse event was reported in the 6 involved literatures. Publication bias can not be analyzed due to few number of involved literatures,thus publication bias can not be ruled out. Conclusion Existing literature evidence suggests that,HIIT can effectively improve the antihypertensive effect,VO_2 max and cardiorespiratory endurance in hypertension patients,slow down the resting heart rate,without obvious influence on BMI.
Objective To evaluate the intervention effect of high intensity interval training(HIIT)on hypertension patients. Methods Computer was used to research databases including PubMed,Web of Science,The Cochrane Library,EBSCO,Wanfang Data,CNKI and VIP from establishment to August 2018,to screen randomized controlled trial about intervention effect of HIIT on hypertension patients. Based on drug therapy,patients in control group received regular activity or moderate intensity exercises,while patients in test group received HIIT. SBP,DBP,VO_2 max,resting heart rate and BMI were compared between the two groups after intervention. RevMan 5.3 software was used to complete the Meta-analysis. Results A total of 6 literatures were enrolled(including 253 patients),thereinto 5 literatures were English,1 literature was Chinese.Meta-analysis results showed that,SBP〔WMD=-4.58,95%CI(-7.51,-1.65)〕,DBP〔WMD=-2.15,95%CI(-3.98,-0.32)〕and resting heart rate〔WMD=-3.24,95%CI(-5.82,-0.65)〕in observation group were statistically significantly lower than those in control group after intervention(P<0.05),while VO_2 max in observation group was statistically significantly higher than that in control group after intervention〔WMD=3.24,95%CI(1.23,5.25),P<0.05〕;no statistically significant difference of BMI was found between the two groups after intervention〔WMD=-0.54,95%CI(-1.87,0.78),P>0.05〕.No adverse event was reported in the 6 involved literatures. Publication bias can not be analyzed due to few number of involved literatures,thus publication bias can not be ruled out. Conclusion Existing literature evidence suggests that,HIIT can effectively improve the antihypertensive effect,VO_2 max and cardiorespiratory endurance in hypertension patients,slow down the resting heart rate,without obvious influence on BMI.
引文
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[12]IZADI M R,GHARDASHI A A,ASVADI F M,et al.Highintensity interval training lowers blood pressure and improves apelin and NOx plasma levels in older treated hypertensive individuals[J].J Physiol Biochem,2018,74(1):47-55.DOI:10.1007/s13105-017-0602-0.
[13]JO E A,CHO K I,LIM D S,et al.Effects of interval training on blood pressure and endothelial function in hypertensive patients[J].IJASS,2018,30(1):50-61.DOI:10.24985/ijass.2018.30.1.50.
[14]MOLMEN-HANSEN H E,STOLEN T,TJONNA A E,et al.Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients[J].Eur J Prev Cardiol,2012,19(2):151-160.DOI:10.1177/1741826711400512.
[15]JURIO-IRIARTE B,BRUBAKER P H,GOROSTEGI-ANDUAGAI,et al.Validity of the modified shuttle walk test to assess cardiorespiratory fitness after exercise intervention in overweight/obese adults with primary hypertension[J].Clin Exp Hypertens,2018,14:1-6.DOI:10.1080/10641963.2018.1481423.
[16]刘向辉,刘君玲.高强度间歇运动对高血压患者Tei指数及BNP的影响[J].邵阳学院学报(自然科学版),2018,15(2):108-116.
[17]KARPOVICH P V.Exercise in medicine:a review[J].Arch Phys Med Rehabil,1968,49(2):66-76.
[18]LURBE E,TORRO I,RODRíGUEZ C,et al.Birth weight influences blood pressure values and variability in children and adolescents[J].Hypertension,2001,38(3):389-393.
[19]BARTLETT J D,CLOSE G L,MACLAREN D P,et al.Highintensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise:implications for exercise adherence[J].J Sports Sci,2011,29(6):547-553.DOI:10.1080/02640414.2010.545427.
[20]王京京,韩涵,张海峰.高强度间歇训练对青年肥胖女性腹部脂肪含量的影响[J].中国运动医学杂志,2015,34(1):15-20,30.
[21]GUIMAR?ES G V,CIOLAC E G,CARVALHO V O,et al.Effects of continuous vs.interval exercise training on blood pressure and arterial stiffness in treated hypertension[J].Hypertens Res,2010,33(6):627-632.DOI:10.1038/hr.2010.42.
[22]LIOU K,HO S,FILDES J,et al.High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease:A Meta-analysis of Physiological and Clinical Parameters[J].Heart Lung Circ,2016,25(2):166-174.DOI:10.1016/j.hlc.2015.06.828.
[23]BOUTCHER Y N,BOUTCHER S H.Exercise intensity and hypertension:what's new?[J].J Hum Hypertens,2017,31(3):157-164.DOI:10.1038/jhh.2016.62.
[24]王念辉,洪平,苏中军.基于身高、体重及肺活量的大学一年级男生最大摄氧量推算方法研究[J].中国运动医学杂志,2018,37(3):202-207.
[25]王娟,张献博,王正珍.规律运动对糖尿病患者心肺耐力的影响-Meta分析[J].北京体育大学学报,2013,36(3):50-56.
[26]王盼盼,李玉倩,刘晓田,等.静息心率与2型糖尿病发病风险的Meta分析[J].中华疾病控制杂志,2017,21(3):245-249.DOI:10.16462/j.cnki.zhjbkz.2017.03.008.
[2]余冰清.运动疗法治疗老年单纯收缩期高血压的研究进展[J].心血管病学进展,2017,38(6):710-714.DOI:10.16806/j.cnki.issn.1004-3934.2016.06.021.
[3]PUGH C B,WALLER A E,MARSHALL S W.Physical activity and public health[J].JAMA,1995,274(7):533.
[4]吴兆苏,霍勇,王文,等.中国高血压患者教育指南(2014年简明版节选二)[J].中国医学前沿杂志(电子版),2014,14(3):182-185.
[5]陆舒婷,张丽娟,张雪芳.初诊高血压病青年患者疾病认知体验的质性研究[J].护理学杂志,2017,32(21):34-36.DOI:10.3870/j.issn.1001-4152.2017.21.034.
[6]杨京辉,汪亚群,楼青青,等.高强度间歇运动对糖尿病前期患者糖脂代谢的影响[J].中国康复医学杂志,2017,32(8):907-911,937.DOI:10.3969/j.issn.1001-1242.2017.08.010.
[7]HOLLOWAY T M,BLOEMBERG D,DA SILVA M L,et al.High Intensity Interval and Endurance Training Have Opposing Effects on Markers of Heart Failure and Cardiac Remodeling in Hypertensive Rats[J].PLoS One,2015,10(3):e0121138.DOI:10.1371/journal.pone.0121138.
[8]CORNELISSEN V A,VERHEYDEN B,AUBERT A E,et al.Effects of aerobic training intensity on resting,exercise and postexercise blood pressure,heart rate and heart-rate variability[J].J Hum Hypertens,2010,24(3):175-182.DOI:10.1038/jhh.2009.51.
[9]国家基本公共卫生服务项目基层高血压管理办公室,基层高血压管理专家委员会.国家基层高血压防治管理指南[J].中国循环杂志,2017,32(11):1041-1048.DOI:10.3969/j.issn.1000-3614.2017.11.001.
[10]Cochrane Handbook For Systematic Reviews Of Interventions Version 5.0.0[EB/OL].[2018-09-10].https://training.cochrane.org/handbook.
[11]GOROSTEGI-ANDUAGA I,CORRES P,MARTINEZAGUIRRE-BETOLAZA A,et al.Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension:EXERDIET-HTA study[J].Eur J Prev Cardiol,2018,25(4):343-353.DOI:10.1177/2047487317749956.
[12]IZADI M R,GHARDASHI A A,ASVADI F M,et al.Highintensity interval training lowers blood pressure and improves apelin and NOx plasma levels in older treated hypertensive individuals[J].J Physiol Biochem,2018,74(1):47-55.DOI:10.1007/s13105-017-0602-0.
[13]JO E A,CHO K I,LIM D S,et al.Effects of interval training on blood pressure and endothelial function in hypertensive patients[J].IJASS,2018,30(1):50-61.DOI:10.24985/ijass.2018.30.1.50.
[14]MOLMEN-HANSEN H E,STOLEN T,TJONNA A E,et al.Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients[J].Eur J Prev Cardiol,2012,19(2):151-160.DOI:10.1177/1741826711400512.
[15]JURIO-IRIARTE B,BRUBAKER P H,GOROSTEGI-ANDUAGAI,et al.Validity of the modified shuttle walk test to assess cardiorespiratory fitness after exercise intervention in overweight/obese adults with primary hypertension[J].Clin Exp Hypertens,2018,14:1-6.DOI:10.1080/10641963.2018.1481423.
[16]刘向辉,刘君玲.高强度间歇运动对高血压患者Tei指数及BNP的影响[J].邵阳学院学报(自然科学版),2018,15(2):108-116.
[17]KARPOVICH P V.Exercise in medicine:a review[J].Arch Phys Med Rehabil,1968,49(2):66-76.
[18]LURBE E,TORRO I,RODRíGUEZ C,et al.Birth weight influences blood pressure values and variability in children and adolescents[J].Hypertension,2001,38(3):389-393.
[19]BARTLETT J D,CLOSE G L,MACLAREN D P,et al.Highintensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise:implications for exercise adherence[J].J Sports Sci,2011,29(6):547-553.DOI:10.1080/02640414.2010.545427.
[20]王京京,韩涵,张海峰.高强度间歇训练对青年肥胖女性腹部脂肪含量的影响[J].中国运动医学杂志,2015,34(1):15-20,30.
[21]GUIMAR?ES G V,CIOLAC E G,CARVALHO V O,et al.Effects of continuous vs.interval exercise training on blood pressure and arterial stiffness in treated hypertension[J].Hypertens Res,2010,33(6):627-632.DOI:10.1038/hr.2010.42.
[22]LIOU K,HO S,FILDES J,et al.High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease:A Meta-analysis of Physiological and Clinical Parameters[J].Heart Lung Circ,2016,25(2):166-174.DOI:10.1016/j.hlc.2015.06.828.
[23]BOUTCHER Y N,BOUTCHER S H.Exercise intensity and hypertension:what's new?[J].J Hum Hypertens,2017,31(3):157-164.DOI:10.1038/jhh.2016.62.
[24]王念辉,洪平,苏中军.基于身高、体重及肺活量的大学一年级男生最大摄氧量推算方法研究[J].中国运动医学杂志,2018,37(3):202-207.
[25]王娟,张献博,王正珍.规律运动对糖尿病患者心肺耐力的影响-Meta分析[J].北京体育大学学报,2013,36(3):50-56.
[26]王盼盼,李玉倩,刘晓田,等.静息心率与2型糖尿病发病风险的Meta分析[J].中华疾病控制杂志,2017,21(3):245-249.DOI:10.16462/j.cnki.zhjbkz.2017.03.008.