In patients with hypertension, aerobic exercise likely produces a clinically meaningful mean expected blood pressure reduction ranging from -4.9 to -12.0 mmHg systolic and -3.4 to -5.8 mmHg diastolic.
The certainty of the evidence is limited by study limitations, inconsistency and publication bias.
Applicability to clinical practice is good, as exercise interventions are feasible in everyday life and even a sustained reduction of a few mmHg in blood pressure is clinically and population-wise meaningful.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias «Additional comments for included studies...»2 |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| «Hanssen H, Boardman H, Deiseroth A, ym. Personaliz...»1 | Systematic review of meta-analyses (meta-review, consensus document) | 34 meta-analysis including adults (≥18 years) with hypertension | Aerobic training vs usual lifestyle or no exercise. | Systolic blood pressure; Diastolic blood pressure | Moderate |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exerci...»2 | MA | 84 studies, including 5065 adults (≥18 years) with hypertension. Europe, Asia, North America, Oceania and others |
Exercise training modalities including aerobic training and combined training (aerobic plus resistance) compared to non-exercise control. | Systolic blood pressure; Diastolic blood pressure | Moderate |
| Reference | Comments |
|---|---|
| «Hanssen H, Boardman H, Deiseroth A, ym. Personaliz...»1 | Adults (>18 years), with and without cardiovascular risk factors, across normal BP, high-normal BP, and hypertension categories. Intervention durations 4-52 weeks. Frequency of the training typically 3x/week. Main exclusions (meta-analyses): Focus on specific diseases (eg, type 2 diabetes or chronic kidney disease), children/adolescents only, acute exercise effects, non-randomized trials, neuromotor exercise (eg, Tai Chi, Yoga), unclear cardiovascular effects, morbidity/mortality as primary endpoint. |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exerci...»2 | Blood pressure measurement setting: Office, home, or ambulatory measurements. Intervention duration: Mean 14.1 ± 7.9 weeks (range 4 to 48 weeks). Exclusion criteria: Trials with BP-lowering medication as part of the intervention. |
Results
| Reference | Mode | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| I=intervention; C=comparison; CI=confidence interval, N/A=not assessed | ||||||
| «Hanssen H, Boardman H, Deiseroth A, ym. Personaliz...»1 | Aerobic training | 21 meta-analysis | NR | N/A | N/A | Mean expected reduction range −4.9 to −12.0 mmHg |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exerci...»2 | Aerobic training Combined training |
56 trials, number of patients not reported. 8 trials, number of patients not reported. |
NR NR |
N/A N/A |
N/A N/A |
−7.85 (−9.55 to −6.15) −7.64 (−11.70 to −3.57) |
| Level of evidence: moderate The quality of evidence is downgraded due to (inconsistency, publication bias). |
||||||
| Reference | Mode | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| I=intervention; C=comparison; CI=confidence interval, N/A=not assessed | ||||||
| «Hanssen H, Boardman H, Deiseroth A, ym. Personaliz...»1 | Aerobic training |
21 meta-analysis, total number of patients not reported. | NR | N/A | N/A | expected range −3.4 to −5.8 mmHg |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exerci...»2 | Aerobic training Combined training |
56 trials, number of patients not reported. 8 trials, number of patients not reported. |
NR NR |
N/A N/A |
N/A N/A |
−4.70 (−5.69 to −3.72) −4.69 (−6.67 to −2.70) |
| Level of evidence: moderate The quality of evidence is downgraded due to (inconsistency, publication bias). |
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