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. 2024 Nov 1.
doi: 10.1038/s41440-024-01974-3. Online ahead of print.

Differences in the effects of exercise on blood pressure depending on the physical condition of the subject and the type of exercise: a systematic review and meta-analysis

Yasunori Suematsu  1 , Hidetaka Morita  2 , Makiko Abe  3 , Yoshinari Uehara  4 , Rie Koyoshi  5 , Kanta Fujimi  6 , Akihito Ideishi  7 , Kohei Takata  8 , Yuta Kato  1 , Tetsuo Hirata  1 , Eiji Yahiro  9 , Natsumi Morito  8 , Ken Kitajima  10 , Yuiko Yano  11 , Atsushi Satoh  12 , Chikara Yoshimura  3 , Shintaro Ishida  3 , Shota Okutsu  13 , Koji Takahashi  14 , Yukiko Shinohara  3 , Takashi Sakaguchi  14 , Shiori Katsuki  14 , Kazuhiro Tada  14 , Takako Fujii  3   15 , Shunsuke Funakoshi  3 , Yaopeng Hu  16 , Tomonori Satoh  17 , Hirofumi Ohnishi  18 , Keisuke Okamura  19 , Hiroyuki Mizuno  20 , Kimika Arakawa  21 , Kei Asayama  22 , Toshio Ohtsubo  23 , Tomoaki Ishigami  24 , Shigeru Shibata  25 , Takayuki Fujita  16 , Masanori Munakata  17 , Mitsuru Ohishi  26 , Atsuhiro Ichihara  27 , Tomohiro Katsuya  28 , Masashi Mukoyama  29 , Hiromi Rakugi  30 , Koichi Node  31 , Hisatomi Arima  3 , Shin-Ichiro Miura  32
Affiliations

Differences in the effects of exercise on blood pressure depending on the physical condition of the subject and the type of exercise: a systematic review and meta-analysis

Yasunori Suematsu et al. Hypertens Res. .

Abstract

Although hypertension is a major cause of cardiovascular disease, the control of blood pressure (BP) is insufficient worldwide. Exercise is an effective treatment for reducing BP, but the differences in the blood pressure lowering effects of exercise according to the underlying pathophysiological condition, the type of exercise, and the geographic region are not fully understood. An umbrella review with a meta-analysis of 435 randomized controlled trials that investigated the BP-lowering effects of exercise was performed using Ovid MEDLINE and the Cochrane Library, covering the period from inception to August 1, 2023. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. Exercise significantly reduced systolic BP in healthy subjects (-3.51 mmHg, 95% confidence interval: -3.90, -3.11; p < 0.001) and in those with lifestyle-related diseases including hypertension (-5.48 mmHg, -6.51, -4.45; p < 0.001), but not in those with cardiovascular diseases (-1.16 mmHg, -4.08, 1.76; p = 0.44). According to the type of exercise, all types significantly reduced systolic BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases. According to the region, in Oceania, there were no reductions in systolic BP. In Asia, systolic BP was reduced in patients with cardiovascular diseases. In conclusion, any type of exercise reduced BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases, and the region affected the effect of exercise. When using exercise to reduce hypertension, it is important to consider the patient's pathophysiological condition and the region.

Keywords: Blood pressure lowering; Exercise therapy; Exercise type; Meta analysis; Pathophysiological condition.

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