Assessment of ACSM adherence.

Numerous studies have demonstrated the positive effects of exercise as a non-pharmacological treatment for hypertensive patients. However, there was a relative lack of research analyzing the effects of different exercise doses on hypertensive individuals. Therefore, the primary objective of this study was to evaluate the impact of different exercise doses on blood pressure (BP) and heart rate (HR) in hypertensive patients through a systematic review and meta-analysis. A systematic search was conducted across four electronic databases (PubMed, Embase, Web of Science, and Cochrane), focusing on the impact of exercise on BP and HR in hypertensive patients, followed by literature screening. Based on the American College of Sports Medicine (ACSM) recommendations for aerobic, resistance, and flexibility exercises in hypertensive patients, the intervention measures from 29 randomized controlled trials were evaluated and categorized as high adherence and low/uncertainty adherence groups according to ACSM recommendations. Differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR between ACSM high and low/uncertainty adherence exercises were reported and evaluated using standardized mean difference (SMD) and 95% confidence interval (95% CI). A total of 25 articles were included, comprising 29 studies, with 16 studies categorized as high adherence with ACSM recommendations and 13 categorized as low or uncertain adherence. For the three outcome measures, the SMD ratio of exercise interventions with high ACSM adherence to those with low or uncertain ACSM adherence was as follows: systolic blood pressure (− 1.20: − 0.75), diastolic blood pressure (− 0.84: − 0.78), and heart rate (− 0.37: − 0.40). The results suggest that exercise interventions with high adherence to ACSM recommendations had a more significant impact on SBP and DBP in hypertensive patients, while the impact on HR was less pronounced than that of interventions with low or uncertain adherence to ACSM recommendations.
This systematic review and meta-analysis was registered in PROSPERO (CRD 42023460293).

众多研究已证实，运动作为高血压患者（hypertensive patients）的非药物治疗（non-pharmacological treatment）手段具有积极效果。然而，目前针对不同运动剂量对高血压个体影响的相关研究仍相对匮乏。因此，本研究的核心目的是通过系统评价（systematic review）与荟萃分析（meta-analysis），评估不同运动剂量对高血压患者血压（blood pressure, BP）及心率（heart rate, HR）的影响。
研究团队通过PubMed、Embase、Web of Science及Cochrane四个电子数据库开展系统性检索，聚焦运动对高血压患者血压与心率的影响，随后进行文献筛选。
参考美国运动医学会（American College of Sports Medicine, ACSM）针对高血压患者的有氧运动、抗阻运动及柔韧性运动指南，本研究对29项随机对照试验（randomized controlled trials）的干预措施进行评估，并依据ACSM指南将其划分为高依从性组与低/不确定依从性组。
本研究以标准化均数差（standardized mean difference, SMD）及95%置信区间（95% confidence interval, 95% CI）为分析指标，报告并评估ACSM高依从性与低/不确定依从性运动干预在收缩压（systolic blood pressure, SBP）、舒张压（diastolic blood pressure, DBP）及心率这三项结局指标上的差异。
最终共纳入25篇文献，合计29项研究，其中16项为符合ACSM指南的高依从性运动干预，13项为低或不确定依从性运动干预。针对三项结局指标，ACSM高依从性与低/不确定依从性运动干预的标准化均数差比值分别为：收缩压（-1.20: -0.75）、舒张压（-0.84: -0.78）及心率（-0.37: -0.40）。
研究结果显示，严格遵循ACSM指南的高依从性运动干预对高血压患者的收缩压与舒张压改善效果更为显著，而其对心率的影响则弱于低或不确定依从性的运动干预。
本项系统评价与荟萃分析已在PROSPERO平台注册（注册号：CRD 42023460293）。