Aerobic Exercise and Resting Blood Pressure in Older Adults: A Meta-Analytic Review of Randomized Controlled Trials
OBJECTIVE: Use the meta-analytic approach to examine the effects of aerobic exercise on resting systolic and diastolic blood pressure in older adults. METHODS: Studies were retrieved from (1) computer searches (MEDLINE, Current Contents, Sport Discus), (2) cross-referencing from bibliographies of retrieved studies and review articles, and (3) expert review of reference list. Inclusion criteria for this study were (1) randomized trials, (2) aerobic activity as the only intervention, (3) nonexercise control group included, (4) changes in resting systolic and/or diastolic blood pressure assessed, (5) within study ages of subjects ≥ 50 years, (6) English-language studies published in journals between January 1966 and January 1998. All studies were coded by both authors, independent of each other. The authors then met and reviewed every item coded. Discrepancies were resolved by consensus. Net changes in blood pressure were calculated as the exercise minus control group difference. RESULTS: A total of 14 primary outcomes were derived from 7 studies. Using a random-effects model, decreases of approximately 2% and 1% were found for resting systolic and diastolic blood pressure, respectively, with only changes in systolic blood pressure statistically significant (systolic, mean ± SD = -2 ± 3 mmHg, 95% confidence interval = -4 to -1; diastolic, mean ± SD = -1 ± 2 mmHg, 95% confidence interval = -2 to 0 mmHg). No statistically significant publication bias was observed for changes in either resting systolic or diastolic blood pressure. Regression analyses revealed a statistically significant association between changes in resting systolic blood pressure and initial systolic blood pressure (R = 0.73, SEE = 0.57, p = 0.003). Changes in blood pressure were independent of changes in body weight, body fat, and body mass index. CONCLUSIONS: Aerobic exercise is efficacious for reducing resting systolic blood pressure in older adults. However, a need exists for additional studies that address the effectiveness of this intervention for reducing resting blood pressure in older adults.