Information de reference pour ce titreAccession Number: | 00000605-200204020-00006.
|
Author: | Whelton, Seamus P.; Chin, Ashley MPH, MA; Xin, Xue MD, MS; He, Jiang MD, PhD
|
Institution: | From Tulane University, New Orleans, Louisiana.
|
Title: | Effect of Aerobic Exercise on Blood Pressure: A Meta-Analysis of Randomized, Controlled Trials.[Article]
|
Source: | Annals of Internal Medicine. 136(7):493-503, April 2, 2002.
|
Abstract: | Purpose: Physical activity has been associated with reduced blood pressure in observational epidemiologic studies and individual clinical trials. This meta-analysis of randomized, controlled trials was conducted to determine the effect of aerobic exercise on blood pressure.
Data Sources: English-language articles published before September 2001.
Study Selection: 54 randomized, controlled trials (2419 participants) whose intervention and control groups differed only in aerobic exercise.
Data Extraction: Using a standardized protocol and data extraction form, three of the investigators independently abstracted data on study design, sample size, participant characteristics, type of intervention, follow-up duration, and treatment outcomes.
Data Synthesis: In a random-effects model, data from each trial were pooled and weighted by the inverse of the total variance. Aerobic exercise was associated with a significant reduction in mean systolic and diastolic blood pressure (-3.84 mm Hg [95% CI, -4.97 to -2.72 mm Hg] and -2.58 mm Hg [CI, -3.35 to -1.81 mm Hg], respectively). A reduction in blood pressure was associated with aerobic exercise in hypertensive participants and normotensive participants and in overweight participants and normal-weight participants.
Conclusions: Aerobic exercise reduces blood pressure in both hypertensive and normotensive persons. An increase in aerobic physical activity should be considered an important component of lifestyle modification for prevention and treatment of high blood pressure.
(C) 2002 American College of Physicians
|
Author Keywords: | Exercise; Blood pressure; Life style; Hypertension; Health behavior.
|
References: | 1.Wolz M, Cutler J, Roccella EJ, Rohde F, Thom T, Burt V. Statement from the National High Blood Pressure Education Program: prevalence of hypertension. Am J Hypertens. 2000;13:103-4. [PMID: 10678279]
2.2000 Heart and Stroke Statistical Update. American Heart Association. Dallas, TX: American Heart Assoc; 1999.
3.He J, Whelton PK. Elevated systolic blood pressure and risk of cardiovascular and renal disease: overview of evidence from observational epidemiologic studies and randomized controlled trials. Am Heart J. 1999;138:211-9. [PMID: 10467215]
4.Whelton PK, He J. Blood pressure reduction. In: Hennekens CH, Buring JE, Manson JE, Ridker PM, eds. Clinical Trials in Cardiovascular Disease. Philadelphia: WB Saunders; 1999.
5.Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med. 1995;155:701-9. [PMID: 7695458]
6.Arroll B, Beaglehole R. Does physical activity lower blood pressure: a critical review of the clinical trials. J Clin Epidemiol. 1992;45:439-47. [PMID: 1588350]
7.Fagard RH. Physical fitness and blood pressure. J Hypertens Suppl. 1993;11(Suppl 5):S47-52. [PMID: 8158433]
8.Kelley GA. Aerobic exercise and resting blood pressure among women: a meta-analysis. Prev Med. 1999;28:264-75. [PMID: 10072745]
9.Kelley GA. Effects of aerobic exercise in normotensive adults: a brief meta-analytic review of controlled clinical trials. South Med J. 1995;88:42-6. [PMID: 7817226]
10.Jennings G, Nelson L, Nestel P, Esler M, Korner P, Burton D, et al. The effects of changes in physical activity on major cardiovascular risk factors, hemodynamics, sympathetic function, and glucose utilization in man: a controlled study of four levels of activity. Circulation. 1986;73:30-40. [PMID: 3510088]
11.Nelson L, Jennings GL, Esler MD, Korner PI. Effect of changing levels of physical activity on blood-pressure and haemodynamics in essential hypertension. Lancet. 1986;2:473-6. [PMID: 2875235]
12.Urata H, Tanabe Y, Kiyonaga A, Ikeda M, Tanaka H, Shindo M, et al. Antihypertensive and volume-depleting effects of mild exercise on essential hypertension. Hypertension. 1987;9:245-52. [PMID: 3546120]
13.Jones DR, Speier J, Canine K, Owen R, Stull GA. Cardiorespiratory responses to aerobic training by patients with postpoliomyelitis sequelae. JAMA. 1989;261:3255-8. [PMID: 2654435]
14.Van Hoof R, Hespel P, Fagard R, Lijnen P, Staessen J, Amery A. Effect of endurance training on blood pressure at rest, during exercise and during 24 hours in sedentary men. Am J Cardiol. 1989;63:945-9. [PMID: 2929469]
15.Akinpelu AO. Responses of the African hypertensive to exercise training: preliminary observations. J Hum Hypertens. 1990;4:74-6. [PMID: 2338694]
16.Martin JE, Dubbert PM, Cushman WC. Controlled trial of aerobic exercise in hypertension. Circulation. 1990;81:1560-7. [PMID: 2184945]
17.Meredith IT, Jennings GL, Esler MD, Dewar EM, Bruce AM, Fazio VA, et al. Time-course of the antihypertensive and autonomic effects of regular endurance exercise in human subjects. J Hypertens. 1990;8:859-66. [PMID: 2172376]
18.Oluseye KA. Cardiovascular responses to exercise in Nigerian women. J Hum Hypertens. 1990;4:77-9. [PMID: 2338695]
19.Suter E, Marti B, Tschopp A, Wanner HU, Wenk C, Gutzwiller F. Effects of self-monitored jogging on physical fitness, blood pressure and serum lipids: a controlled study in sedentary middle-aged men. Int J Sports Med. 1990;11:425-32. [PMID: 2286480]
20.Blumenthal JA, Siegel WC, Appelbaum M. Failure of exercise to reduce blood pressure in patients with mild hypertension. Results of a randomized controlled trial. JAMA. 1991;266:2098-104. [PMID: 1920698]
21.Meredith IT, Friberg P, Jennings GL, Dewar EM, Fazio VA, Lambert GW, et al. Exercise training lowers resting renal but not cardiac sympathetic activity in humans. Hypertension. 1991;18:575-82. [PMID: 1937659]
22.Duncan JJ, Gordon NF, Scott CB. Women walking for health and fitness. How much is enough? JAMA. 1991;266:3295-9. [PMID: 1960829]
23.King AC, Haskell WL, Taylor CB, Kraemer HC, DeBusk RF. Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. JAMA. 1991;266:1535-42. [PMID: 1880885]
24.Posner JD, Gorman KM, Windsor-Landsberg L, Larsen J, Bleiman M, Shaw C, et al. Low to moderate intensity endurance training in healthy older adults: physiological responses after four months. J Am Geriatr Soc. 1992;40:1-7. [PMID: 1727835]
25.Radaelli A, Piepoli M, Adamopoulos S, Pipilis A, Clark SJ, Casadei B, et al. Effects of mild physical activity, atenolol and the combination on ambulatory blood pressure in hypertensive subjects. J Hypertens. 1992;10:1279-82. [PMID: 1335012]
26.Hamdorf PA, Withers RT, Penhall RK, Haslam MV. Physical training effects on the fitness and habitual activity patterns of elderly women. Arch Phys Med Rehabil. 1992;73:603-8. [PMID: 1622313]
27.Albright CL, King AC, Taylor CB, Haskell WL. Effect of a six-month aerobic exercise training program on cardiovascular responsivity in healthy middle-aged adults. J Psychosom Res. 1992;36:25-36. [PMID: 1538348]
28.Kingwell BA, Jennings GL. Effects of walking and other exercise programs upon blood pressure in normal subjects. Med J Aust. 1993;158:234-8. [PMID: 8426544]
29.Braith RW, Pollock ML, Lowenthal DT, Graves JE, Limacher MC. Moderate- and high-intensity exercise lowers blood pressure in normotensive subjects 60 to 79 years of age. Am J Cardiol. 1994;73:1124-8. [PMID: 8198040]
30.Lindheim SR, Notelovitz M, Feldman EB, Larsen S, Khan FY, Lobo RA. The independent effects of exercise and estrogen on lipids and lipoproteins in postmenopausal women. Obstet Gynecol. 1994;83:167-72. [PMID: 8290176]
31.Wijnen JA, Kool MJ, van Baak MA, Kuipers H, de Haan CH, Verstappen FT, et al. Effect of exercise training on ambulatory blood pressure. Int J Sports Med. 1994;15:10-5. [PMID: 8163319]
32.Arroll B, Beaglehole R. Salt restriction and physical activity in treated hypertensives. N Z Med J. 1995;108:266-8. [PMID: 7637923]
33.Potempa K, Lopez M, Braun LT, Szidon JP, Fogg L, Tincknell T. Physiological outcomes of aerobic exercise training in hemiparetic stroke patients. Stroke. 1995;26:101-5. [PMID: 7839377]
34.Leon AS, Casal D, Jacobs D Jr. Effects of 2,000 kcal per week of walking and stair climbing on physical fitness and risk factors for coronary heart disease. J Cardiopulm Rehabil. 1996;16:183-92. [PMID: 8761839]
35.Okumiya K, Matsubayashi K, Wada T, Kimura S, Doi Y, Ozawa T. Effects of exercise on neurobehavioral function in community-dwelling older people more than 75 years of age. J Am Geriatr Soc. 1996;44:569-72. [PMID: 8617907]
36.Rogers MW, Probst MM, Gruber JJ, Berger R, Boone JB Jr. Differential effects of exercise training intensity on blood pressure and cardiovascular responses to stress in borderline hypertensive humans. J Hypertens. 1996;14:1369-75. [PMID: 8934367]
37.Ready AE, Naimark B, Ducas J, Sawatzky JV, Boreskie SL, Drinkwater DT, et al. Influence of walking volume on health benefits in women post-menopause. Med Sci Sports Exerc. 1996;28:1097-105. [PMID: 8882996]
38.Gordon NF, Scott CB, Levine BD. Comparison of single versus multiple lifestyle interventions: are the antihypertensive effects of exercise training and diet-induced weight loss additive? Am J Cardiol. 1997;79:763-7. [PMID: 9070555]
39.Wang JS, Jen CJ, Chen HI. Effects of chronic exercise and deconditioning on platelet function in women. J Appl Physiol. 1997;83:2080-5. [PMID: 9390984]
40.Duey WJ, O'Brien WL, Crutchfield AB, Brown LA, Williford HN, Sharff-Olson M. Effects of exercise training on aerobic fitness in African-American females. Ethn Dis. 1998;8:306-11. [PMID: 9926900]
41.Sakai T, Ideishi M, Miura S, Maeda H, Tashiro E, Koga M, et al. Mild exercise activates renal dopamine system in mild hypertensives. J Hum Hypertens. 1998;12:355-62. [PMID: 9705036]
42.Wing RR, Venditti E, Jakicic JM, Polley BA, Lang W. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care. 1998;21:350-9. [PMID: 9540015]
43.Murphy MH, Hardman AE. Training effects of short and long bouts of brisk walking in sedentary women. Med Sci Sports Exerc. 1998;30:152-7. [PMID: 9475657]
44.Higashi Y, Sasaki S, Sasaki N, Nakagawa K, Ueda T, Yoshimizu A, et al. Daily aerobic exercise improves reactive hyperemia in patients with essential hypertension. Hypertension. 1999;33:591-7. [PMID: 9931171]
45.Higashi Y, Sasaki S, Kurisu S, Yoshimizu A, Sasaki N, Matsuura H, et al. Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation. 1999;100:1194-202. [PMID: 10484540]
46.Cooper AR, Moore LA, McKenna J, Riddoch CJ. What is the magnitude of blood pressure response to a programme of moderate intensity exercise? Randomised controlled trial among sedentary adults with unmedicated hypertension. Br J Gen Pract. 2000;50:958-62. [PMID: 11224966]
47.Blumenthal JA, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning. Arch Intern Med. 2000;160:1947-58. [PMID: 10888969]
48.Rice JA. Mathematical Statistics and Data Analysis. Belmont, MA: Duxbury Pr; 1988.
49.Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol. 1992;45:769-73. [PMID: 1619456]
50.DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177-88. [PMID: 3802833]
51.Begg CB. Publication bias. In: Cooper H, Hedges LV, eds. The Handbook of Research Synthesis. New York: Russell Sage Foundation; 1994:399-409.
52.Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56:455-63. [PMID: 10877304]
53.Duval S, Tweedie R. A nonparametric "trim and fill" method of accounting for publication bias in meta-analysis. Journal of the American Statistical Association. 2000;95:89-98.
54.The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med. 1997;157:2413-46. [PMID: 9385294]
55.National High Blood Pressure Education Program Working Group report on primary prevention of hypertension. Arch Intern Med. 1993;153:186-208. [PMID: 8422207]
56.Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37:1595-607. [PMID: 3056758]
57.He J, Klag MJ, Caballero B, Appel LJ, Charleston J, Whelton PK. Plasma insulin levels and incidence of hypertension in African Americans and whites. Arch Intern Med. 1999;159:498-503. [PMID: 10074959]
58.Brown MD, Moore GE, Korytkowski MT, McCole SD, Hagberg JM. Improvement of insulin sensitivity by short-term exercise training in hypertensive African American women. Hypertension. 1997;30:1549-53. [PMID: 9403581]
59.Kokkinos PF, Narayan P, Colleran JA, Pittaras A, Notargiacomo A, Reda D, et al. Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension. N Engl J Med. 1995;333:1462-7. [PMID: 7477146]
60.Brett SE, Ritter JM, Chowienczyk PJ. Diastolic blood pressure changes during exercise positively correlate with serum cholesterol and insulin resistance. Circulation. 2000;101:611-5. [PMID: 10673252]
61.Cutler JA, Follmann D, Allender PS. Randomized trials of sodium reduction: an overview. Am J Clin Nutr. 1997;65:643S-651S. [PMID: 9022560]
62.Whelton PK, He J, Cutler JA, Brancati FL, Appel LJ, Follmann D, et al. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA. 1997;277:1624-32. [PMID: 9168293]
63.Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2001;38:1112-7. [PMID: 11711507]
|
Language: | English.
|
Document Type: | Articles.
|
Journal Subset: | Clinical Medicine.
|
ISSN: | 0003-4819
|
NLM Journal Code: | 0372351, 5a6
|
Annotation(s) | |
|
|