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Will Exercise Advice Be Sufficient for Treatment of Young Adults With Prehypertension and Hypertension? A Systematic Review and Meta-Analysis

期刊

HYPERTENSION
卷 68, 期 1, 页码 78-+

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.116.07431

关键词

cardiovascular disease; exercise; hypertension; lifestyle; meta-analysis

资金

  1. Wellcome Trust [105741/Z/14/Z]
  2. British Heart Foundation (BHF)
  3. Oxford BHF Centre for Research Excellence
  4. Oxford National Institute of Health Research (NIHR) Biomedical Research Centre
  5. NIHR (UK) Academic Clinical Fellowship program
  6. Wellcome Trust [105741/Z/14/Z] Funding Source: Wellcome Trust
  7. National Institutes of Health Research (NIHR) [NIHR-IPF-15-09-14] Funding Source: National Institutes of Health Research (NIHR)
  8. British Heart Foundation [PG/13/58/30397, FS/11/65/28865] Funding Source: researchfish
  9. Cancer Research UK [16895] Funding Source: researchfish
  10. National Institute for Health Research [ACF-2013-13-015, NIHR-IPF-15-09-14] Funding Source: researchfish

向作者/读者索取更多资源

Previous studies report benefits of exercise for blood pressure control in middle age and older adults, but longer-term effectiveness in younger adults is not well established. We performed a systematic review and meta-analysis of published randomized control trials with meta-regression of potential effect modifiers. An information specialist completed a comprehensive search of available data sources, including studies published up to June 2015. Authors applied strict inclusion and exclusion criteria to screen 9524 titles. Eligible studies recruited younger adults with a cardiovascular risk factor (with at least 25% of cohort aged 18-40 years); the intervention had a defined physical activity strategy and reported blood pressure as primary or secondary outcome. Meta-analysis included 14 studies randomizing 3614 participants, mean age 42.2 +/- 6.3 (SD) years. At 3 to 6 months, exercise was associated with a reduction in systolic blood pressure of -4.40 mm Hg (95% confidence interval, -5.78 to -3.01) and in diastolic blood pressure of -4.17 mm Hg (95% confidence interval, -5.42 to -2.93). Intervention effect was not significantly influenced by baseline blood pressure, body weight, or subsequent weight loss. Observed intervention effect was lost after 12 months of follow-up with no reported benefit over control, mean difference in systolic blood pressure -1.02 mm Hg (95% confidence interval, -2.34 to 0.29), and in diastolic blood pressure -0.91 mm Hg (95% confidence interval, -1.85 to 0.02). Current exercise guidance provided to reduce blood pressure in younger adults is unlikely to benefit long-term cardiovascular risk. There is need for continued research to improve age-specific strategies and recommendations for hypertension prevention and management in young adults.

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