METHODS: A comprehensive search was conducted on PubMed, Embase, Web of Science, ProQuest, Cochrane Library, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov website from inception to September 30, 2023, to identify the randomized controlled trials (RCTs), which evaluated the effectiveness of exercise training on arterial stiffness and blood pressure in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random/fixed effects models. Quality assessment was performed using the modified Jadad scale and the Cochrane Risk of Bias Tool. Sensitivity analysis and subgroup analysis were conducted based on drug dosage, treatment duration, and age of administration to further explore potential heterogeneity. Funnel plots were performed to assess publication bias and Begg\'s regression test was carried out for funnel plot asymmetry.
RESULTS: Twenty-two RCTs involving 1978 participants were included in the quantitative analysis. The mean quality of eligible studies was 4.2 out of 7 based on the modified Jadad scale. The results indicated that exercise training had a significant effect on reducing brachial-ankle pulse wave velocity [MD = - 0.69, 95%CI (- 1.11, - 0.27), P = 0.001], decreasing augmentation index (AIx) [MD = - 6.00, 95%CI (- 6.39, - 5.61), P < 0.00001] and AIx normalized to a heart rate of 75 beats per minute (AIx@75%) [MD = - 7.01, 95%CI - 7.91 to - 6.12, P < 0.00001], lowering systolic blood pressure [MD = - 6.19, 95%CI - 9.24 to - 3.15, P < 0.0001], diastolic blood pressure [MD = - 3.57, 95%CI (- 6.10, - 1.03), P = 0.006) and pulse pressure [MD = - 8.52, 95%CI (- 16.27, - 0.76), P = 0.03]. Subgroup analysis revealed that baseline blood pressure levels had a large impact on the effect of exercise training.
CONCLUSIONS: The systematic review and meta-analysis suggested that exercise training may ameliorate arterial stiffness and reduce blood pressure in postmenopausal women with elevated blood pressure. However, the optimal mode of exercise training that improves arterial stiffness and blood pressure in this population requires further investigation.
BACKGROUND: PROSPERO CRD42021211268.
方法:在PubMed上进行了全面搜索,Embase,WebofScience,ProQuest,科克伦图书馆,Cochrane中央控制试验登记册,和ClinicalTrials.gov网站从成立到2023年9月30日,以确定随机对照试验(RCTs),评估了运动训练对绝经后妇女动脉僵硬度和血压的有效性。标准化平均差(SMD),加权平均差(WMD),使用随机/固定效应模型计算95%置信区间(95%CIs)。使用改良的Jadad量表和Cochrane偏差风险工具进行质量评估。根据药物剂量进行敏感性分析和亚组分析,治疗持续时间,和给药年龄,以进一步探索潜在的异质性。进行漏斗图以评估发表偏倚,并对漏斗图不对称进行Begg回归检验。
结果:涉及1978名参与者的22个随机对照试验被纳入定量分析。根据改良的Jadad量表,合格研究的平均质量为7项研究中的4.2项。结果表明,运动训练对降低臂踝脉搏波传导速度有显著影响[MD=-0.69,95CI(-1.11,-0.27),P=0.001],递减增强指数(AIX)[MD=-6.00,95CI(-6.39,-5.61),P<0.00001]和AIx归一化为心率每分钟75次(AIx@75%)[MD=-7.01,95CI-7.91至-6.12,P<0.00001],降低收缩压[MD=-6.19,95CI-9.24至-3.15,P<0.0001],舒张压[MD=-3.57,95CI(-6.10,-1.03),P=0.006)和脉压[MD=-8.52,95CI(-16.27,-0.76),P=0.03]。亚组分析显示,基线血压水平对运动训练的效果有很大影响。
结论:系统评价和荟萃分析表明,运动训练可以改善绝经后高血压妇女的动脉僵硬度和降低血压。然而,改善该人群动脉僵硬度和血压的最佳运动训练方式需要进一步研究。
背景:PROSPEROCRD42021211268。