Abstract 11206: Exercise Training for Blood Pressure: A Systematic Review and Meta-Analysis

Abstract

Background We conducted meta-analyses examining the effects of endurance, dynamic resistance, combined dynamic endurance and resistance training and isometric resistance training on resting blood pressure (BP). The aims were: (1) Quantify and compare BP changes for each training modality. (2) Identify patient sub-groups exhibiting largest BP changes.

Methods A systematic search was conducted; Medline (Ovid) (1950-February 2012), Embase.com (1974- February 2012), Cochrane Central Register of Controlled Trials and CINAHL (1981- February 2012) identifying studies meeting inclusion criteria: Randomized, controlled parallel design trials ≥ 4 weeks; exercise was sole intervention; adult participants (≥18 years); no other concomitant disease; articles from peer-reviewed journals.

Results We included 93 trials, involving 105 endurance, 29 dynamic resistance, 14 combined and 5 isometric resistance groups, totalling 5223 participants (3401 exercise, 1822 control). Systolic BP (SBP) was reduced following endurance [-3.5 mmHg (95% CI, -4.6 to -2.3)], dynamic resistance [-1.8 mmHg (-3.7 to -0.011)] and isometric resistance [-10.9 mmHg (-14.5 to -7.4)], but not combined training. Reductions in diastolic BP (DBP) were observed after endurance [-2.5 mmHg (-1.7 to -3.2)], dynamic resistance [-3.2 mmHg (-2.0 to -4.5)], isometric resistance [-6.2 (-2.0 to -10.3)] and combined [-2.2 mmHg (-0.48 to -3.94)] training. BP reductions (SBP/DBP) following endurance training were greater (p<0.0001) in 26 hypertensive study groups [-8.3 (-6.0 to 10.7)/-5.2 (3.4 to 6.8) mmHg than 50 pre-hypertensive groups [-2.1 (-3.3 to -0.83)/ -1.7 (-2.73 to -0.68)] and 29 normal BP groups -0.75(-2.2 to -0.69)/-1.1 (-2.2 to -0.068 )]. BP reductions (SBP/DBP) following dynamic resistance training were largest for pre-hypertensive participants [-4.0 (-7.4 to -0.5) mmHg/ -3.8 (-5.7 to -1.9) mmHg)] compared to patients with hypertension or optimal BP.

Conclusions Endurance, dynamic resistance and isometric resistance training lower systolic and diastolic BP, while combined training only lowers diastolic BP. Isometric resistance training produces largest reductions in SBP.