THE EFFECTIVENESS OF EXERCISE TRAINING IN LOWERING BLOOD-PRESSURE - AMETAANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF 4 WEEKS OR LONGER

Objective: To identify the features of an optimal exercise programme i n terms of type of exercise, intensity and frequency that would maximi se the training induced decrease in blood pressure (BP). Data identifi cation: Trials were identified by a systematic search of Medline, Emba se and Science Citation Index (SCI), previous review articles and the references of relevant trials, from 1980 until 1996, including only En glish language studies. Study selection: The inclusion criteria were l imited to randomised controlled trials of aerobic or resistance exerci se training conducted over a minimum of 4 weeks where systolic and dia stolic BP was measured. Results: A total of 29 studies (1533 hypertens ive and normotensive participants) were included, 26 used aerobic exer cise training, two trials used resistance training and one study had b oth resistance and aerobic training groups. Aerobic exercise training reduced systolic BP by 4.7 mm Hg (95% Cl: 4.4, 5.0) and diastolic BP b y 3.1 mm Hg (95% Cl: 3.0, 3.3) as compared to a non-exercising control group, however, significant heterogeneity was observed between trials in the analysis. The BP reduction seen with aerobic exercise training was independent of the intensity of exercise and the number of exerci se sessions per week. The evidence for the effect of resistance exerci se training was inconclusive. Conclusions: Aerobic exercise training h ad a small but clinically significant effect in reducing systolic and diastolic BP. Increasing exercise intensity above 70% VO2 max or incre asing exercise frequency to more than three sessions per week did not have any additional impact on reducing BP.