Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and doseresponsemeta-analysis of randomized trials

We aimed to evaluate the dose-dependent effects of aerobic exercise on systolic (SBP) and diastolic blood pressure(DBP) and haemodynamic factors in adults with hypertension. PubMed, Scopus, and Web of Science weresearched to April ۲۰۲۲ for randomized trials of aerobic exercise in adults with hypertension. We conducted arandom-effects meta-analysis to estimate mean differences (MDs) and ۹۵%CIs for each ۳۰ min/week increase inaerobic exercise. The certainty of evidence was rated using the GRADE approach. The analysis of ۳۴ trials with۱۷۸۷ participants indicated that each ۳۰ min/week aerobic exercise reduced SBP by ۱.۷۸ mmHg (۹۵%CI: -۲.۲۲to -۱.۳۳; n=۳۴, GRADE=low), DBP by ۱.۲۳ mmHg (۹۵%CI: -۱.۵۳ to -۰.۹۳; n=۳۴, GRADE=moderate), restingheart rate (MD= -۱.۰۸ bpm, ۹۵%CI: -۱.۴۶ to -۰.۷۱; n=۲۳, GRADE=low), and mean arterial pressure (MD= -۱.۳۷mmHg, ۹۵%CI: -۱.۸۰ to -۰.۹۳; n=۹, GRADE=low). A nonlinear dose-dependent decrement was seen on SBP andDBP, with the greatest decrement at ۱۵۰ min/week (MD۱۵۰ min/week = -۷.۲۳ mmHg, ۹۵%CI: -۹.۰۸ to -۵.۳۹ for SBPand -۵.۵۸ mmHg, ۹۵%CI: -۶.۹۰ to -۴.۲۷ for DBP). Aerobic exercise can lead to a large and clinically importantreduction in blood pressure in a dose-dependent manner, with the greatest reduction at ۱۵۰ min/week.