Background

High blood pressure is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing blood pressure, it is crucial to identify the most effective physical activity intervention. This systematic review and network meta-analysis (NMA) aimed to evaluate the available evidence on the effectiveness of various physical activity interventions for reducing blood pressure and to determine their hierarchy based on their impact on blood pressure.

Methods

A search of PubMed, SPORTDiscus, PsycINFO, Web of Science, CINAHL, Cochrane, and Eric databases was conducted up to December 2022 for this systematic review and NMA. Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6–12 years old were included in this study. Only studies that compared controlled and intervention groups using physical activity or exercise as the major influence were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent investigators performed the literature screening, data extraction, and risk of bias assessment. We used Bayesian Arm-based NMA to synthesize the data. The primary outcomes were systolic blood pressure and diastolic blood pressure. We calculated the mean differences (MD) in systolic blood pressure and diastolic blood pressure before and after treatment. Mean treatment differences were estimated using NMA and random-effect models.

Results

We synthesized 27 studies involving 15,220 children and adolescents. Physical activity combined with nutrition and behavior change was the most effective intervention for reducing both systolic blood pressure and diastolic blood pressure ((MD: –8.64, 95% credible interval (95%CI):–11.44 to –5.84); (MD: –6.75, 95%CI: –10.44 to –3.11)), followed by interventions with multiple components ((MD: –1.39, 95%CI: –1.94 to –0.84); (MD: –2.54, 95%CI: –4.89 to –0.29)).

Conclusion

Our findings suggest that physical activity interventions incorporating nutrition and behavior change, followed by interventions with multiple components, are most effective for reducing both systolic blood pressure and diastolic blood pressure in children and adolescents.

中文翻译：

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体力活动干预对儿童和青少年血压的有效性：系统评价和网络荟萃分析

背景

高血压是死亡率和心血管疾病的主要原因。尽管众所周知运动对于降低血压有好处，但确定最有效的身体活动干预措施至关重要。这项系统评价和网络荟萃分析 (NMA) 旨在评估各种身体活动干预措施对于降低血压的有效性的现有证据，并根据其对血压的影响确定其等级。

方法

本系统评价和 NMA 已于 2022 年 12 月之前对 PubMed、SPORTDiscus、PsycINFO、Web of Science、CINAHL、Cochrane 和 Eric 数据库进行了检索。本研究纳入了针对6-12岁健康儿童和青少年的随机对照试验和准实验研究。仅纳入使用体力活动或锻炼作为主要影响来比较对照组和干预组的研究。我们遵循系统评价和荟萃分析指南的首选报告项目。三名独立研究者进行了文献筛选、数据提取和偏倚风险评估。我们使用基于 Bayesian Arm 的 NMA 来合成数据。主要结局是收缩压和舒张压。我们计算了治疗前后收缩压和舒张压的平均差（MD）。使用 NMA 和随机效应模型估计平均治疗差异。

结果

我们综合了 27 项研究，涉及 15,220 名儿童和青少年。体力活动结合营养和行为改变是降低收缩压和舒张压的最有效干预措施（（MD：–8.64，95％可信区间（95％CI）：–11.44至–5.84）；（MD： –6.75, 95%CI: –10.44 至 –3.11))，然后采用多种成分进行干预 ((MD: –1.39, 95%CI: –1.94 至 –0.84)；(MD: –2.54, 95%CI: – 4.89 至 –0.29))。

结论

我们的研究结果表明，结合营养和行为改变的体育活动干预措施，以及随后的多种干预措施，对于降低儿童和青少年的收缩压和舒张压最有效。