Effect of Physical Exercise on Cardiac Autonomic Modulation in Hypertensive Individuals: A Systematic Review and Meta-analysis.

IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE Current Hypertension Reviews Pub Date : 2023-01-01 DOI:10.2174/1573402119666230803090330

Ayesha Miraj Abidi, Aqsa Mujaddadi, Shahid Raza, Jamal Ali Moiz

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Abstract

Background: Cardiac autonomic dysfunction is associated with hypertension and exercise training (ET) in healthy individuals is found to improve cardiac autonomic modulation (CAM). However, the effects of physical exercise on CAM in hypertensive individuals are under debate.

Objective: The aim of the review is to systematically evaluate the literature on the effects of physical exercise on CAM in hypertensive individuals and analyse comparative differences in the effects of exercise between hypertensive and normotensive individuals.

Methods: Electronic databases, such as Pubmed, PEDro, Scopus, and Web of Science, were systematically searched from inception up to February, 2022, evaluating the effect of ET on CAM either by heart rate variability (HRV), baroreflex sensitivity or heart rate recovery. Fifteen studies were included in the review. The risk of bias was assessed using the Cochrane risk of bias tool version 2 and the risk of bias in studies of intervention (ROBINS-I) tool. The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation approach. Ten studies were included in the quantitative analysis. The meta-analysis and sensitivity analysis were performed using review manager 5.4.1; publication bias was assessed using Jamovi 2.2.5 software.

Results: The qualitative analysis revealed low to moderate certainty of evidence for ET and moderate for aerobic training. For the effect of overall ET, the analysis revealed that the standardized mean differences (SMD) showed a significant effect of ET on HF (SMD 1.76, p = 0.04) and RMSSD (SMD 1.19, p < 0.0001) and a significant decrease in LF (SMD -1.78, p = 0.04). Aerobic training revealed nonsignificant improvement in HRV parameters. In the comparative analysis, ET did not show a significant difference in improvement between hypertensive and normotensive individuals.

Conclusion: This review suggests an improvement in CAM with physical exercise in hypertensive individuals, but the overall effect of ET in hypertensive individuals must be interpreted with caution as the robustness of the data is compromised in the sensitivity analysis of the trials. High-quality future trials focusing on different modes of ET interventions are needed to strengthen the findings of the present review.

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体育锻炼对高血压患者心脏自主神经调节的影响：系统回顾与元分析》。

背景：心脏自律神经功能失调与高血压有关，而对健康人进行运动训练（ET）可改善心脏自律神经调节（CAM）。然而，体育锻炼对高血压患者心脏自律调节的影响还存在争议：本综述旨在系统评估有关体育锻炼对高血压患者 CAM 影响的文献，并分析高血压患者和正常血压患者在锻炼效果方面的比较差异：方法：系统检索了 Pubmed、PEDro、Scopus 和 Web of Science 等电子数据库（从开始到 2022 年 2 月）中通过心率变异性 (HRV)、气压反射敏感性或心率恢复评估 ET 对 CAM 影响的文献。15 项研究被纳入综述。偏倚风险采用 Cochrane 第 2 版偏倚风险工具和干预研究偏倚风险（ROBINS-I）工具进行评估。证据的总体质量采用建议分级、评估、开发和评价方法进行评估。定量分析纳入了 10 项研究。使用 review manager 5.4.1 进行了荟萃分析和敏感性分析；使用 Jamovi 2.2.5 软件评估了发表偏倚：定性分析显示，ET和有氧训练的证据确定性分别为中低。对于整体 ET 的效果，分析显示标准化平均差（SMD）显示 ET 对高频（SMD 1.76，p = 0.04）和 RMSSD（SMD 1.19，p < 0.0001）有显著影响，对低频（SMD -1.78，p = 0.04）有显著降低。有氧训练对心率变异参数的改善不明显。在对比分析中，ET 对高血压和正常血压人群的改善没有显示出明显差异：本综述表明，体育锻炼可改善高血压患者的 CAM，但必须谨慎解释 ET 对高血压患者的总体影响，因为试验的敏感性分析会影响数据的稳健性。今后还需要进行侧重于不同ET干预模式的高质量试验，以加强本综述的研究结果。

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来源期刊

Current Hypertension Reviews PERIPHERAL VASCULAR DISEASE-

CiteScore

4.80

自引率

0.00%

发文量

期刊介绍： Current Hypertension Reviews publishes frontier reviews/ mini-reviews, original research articles and guest edited thematic issues on all the latest advances on hypertension and its related areas e.g. nephrology, clinical care, and therapy. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all clinicians and researchers in the field of hypertension.