Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials

Methodology

Meta-analysis

Population

270 RCTs, n=15,827 participants, 358 effect sizes; normotensive, pre-hypertensive and hypertensive adults

Intervention

Aerobic exercise training (AET), dynamic resistance training (RT), combined training (CT), high-intensity interval training (HIIT) and isometric exercise training (IET) vs. control, compared in a network meta-analysis

Findings

All exercise modalities significantly reduced resting blood pressure. Isometric exercise training ranked first by a wide margin, followed by combined training, with resistance training, aerobic training and HIIT closely grouped behind. Resistance training is a fully legitimate antihypertensive modality, and low-cost isometric work is the most effective single modality identified.

Outcome measures

Resting systolic blood pressure (SBP) and diastolic blood pressure (DBP)

Limitations

Network meta-analysis relies on indirect comparisons where few head-to-head trials exist; the isometric-exercise evidence base is smaller and less robust than the top ranking suggests; pooled populations mix normotensive and hypertensive participants; long-term adherence and hard cardiovascular outcomes not assessed.

Original source

DOI: 10.1136/bjsports-2022-106503 · PMID: 37491419