Background

Exercise recommendations for hypertensive individuals encourage the use of aerobic training (AT) for lowering blood pressure (BP). However, it is not clear whether equivalent BP-lowering effects are obtained with different exercise training types in older adults, among whom hypertension is more prevalent.

Design

We meta-analyzed previous literature testing different types of training [AT, resistance (RT) and combined (CT)] effects on casual systolic BP (SBP) and diastolic BP (DBP), taking into account age and baseline BP influences.

Methods

Randomized controlled trials (RCTs), published up to August 2019 (PubMed), assessing exercise training effects on BP in hypertensive older adults (aged ≥50 years) were included (11, 8 and 3 RCTs tested the effects of AT, RT and CT, respectively).

Results and conclusions

First, both AT and RT reduced SBP (−12.31 [−16.39; −8.24] and − 6.76 [−8.36; −5.17] mm Hg, respectively) and DBP (−4.31 [−5.96; −2.65] and − 3.53 [−4.22; −2.85] mm Hg, respectively) in older adults, while there was not enough evidence for the effects of CT on SBP, due to high variance among the small number of CT studies. Second, training-induced BP reductions were more prominent in patients <65 years compared to those >65 years. However, this difference was mostly driven by differences between AT and CT versus RT intervention on age subgroups. Third, baseline BP values, rather than type of exercise and age, were the main determinant of BP response to exercise (predicted 74% and 53% of SBP and DBP reduction, respectively), indicating this is a major confounding factor to be considered in studies evaluating the impact of exercise training on BP.

中文翻译：

---

基线血压和运动类型是否会影响高血压老年人训练所致的降低水平？对照试验的荟萃分析。

背景

针对高血压个体的运动建议鼓励使用有氧训练（AT）来降低血压（BP）。但是，尚不清楚在老年人中高血压的流行程度不同，通过不同的运动训练类型是否可以获得与之等效的降低血压的效果。

设计

我们对先前的文献进行荟萃分析，测试了不同类型的训练[AT，抵抗力（RT）和综合（CT）]对休闲收缩压（SBP）和舒张压（DBP）的影响，同时考虑了年龄和基线BP的影响。

方法

截至2019年8月（PubMed）公布的随机对照试验（RCT），评估了运动训练对高血压老年人（≥50岁）对BP的影响（11、8和3个RCT测试了AT，RT和CT的作用， 分别）。

结果与结论

首先，AT和RT均降低了SBP（分别为−12.31 [−16.39; −8.24]和− 6.76 [−8.36; −5.17] mm Hg）和DBP（−4.31 [−5.96; -2.65]和− 3.53 [-年龄分别为4.22; -2.85] mm Hg），但由于少量CT研究之间存在较大差异，因此尚无足够证据证明CT对SBP有影响。第二，<65岁的患者与65岁以上的患者相比，训练引起的BP降低更为明显。然而，这种差异主要是由年龄组的AT和CT与RT干预之间的差异所致。第三，基线血压值而不是运动类型和年龄是血压对运动反应的主要决定因素（分别预测SBP和DBP降低分别为74％和53％），