Acute aerobic exercise induces short-term reductions in ambulatory blood pressure in patients with hypertension: a systematic review and meta-analysis

Abstract

Chronic exercise reduces clinic and ambulatory blood pressure (BP), but the short-term effects of an acute exercise bout on ambulatory BP have not been studied widely. We reviewed the literature regarding the short-term effects of acute exercise on ambulatory BP in patients with hypertension and considered moderating factors (medication status and exercise modality/intensity) on ambulatory BP outcomes. A systematic search was conducted (PubMed, Cochrane Library, and Scopus; since inception to January 1, 2021) for crossover randomized controlled trials assessing the short-term effects of acute exercise on ambulatory BP in hypertensive individuals versus nonexercise control conditions. A meta-analysis was conducted for 24-hour, daytime, and nighttime systolic and diastolic BP. Subanalyses also were performed attending to medication status and exercise modality/intensity. Thirty-seven studies (N=822) met the inclusion criteria. A single acute exercise bout reduces 24-hour (systolic BP, −1.6 mm Hg [95% CI, −2.4 to −0.8] for all exercise modalities combined; diastolic BP, −1.0 mm Hg [95% CI, −1.5 to −0.5]), daytime (−3.1 mm Hg [95% CI, −4.1 to −2.2]; -2.0 mm Hg [95% CI, −2.8 to −1.2]), and nighttime ambulatory BP (−1.8 mm Hg [95% CI, −3.0 to −0.6]; −1.5 mm Hg [95% CI, −2.3 to −0.6]), respectively. The magnitude of the effect appears similar in medicated and nonmedicated patients. In separate analyses for exercise modalities, aerobic exercises reduce all ambulatory BP measures (P<0.001) yet with no significant effects for resistance or combined (aerobic and resistance) exercise for any ambulatory BP measure. Vigorous aerobic exercise tends to produce the largest effects. A single bout of acute aerobic exercise, reduces ambulatory BP over 24 hours in medicated and nonmedicated hypertensive adults.