Aerobic exercise reduces blood pressure in both hypertensive and normotensive persons.

Effect of aerobic exercise on blood pressure: a meta-analysis of randomized controlled trials. Questions: Does aerobic exercise reduce blood pressure? If so, who responds, how large is the effect and what types of aerobic exercise are effective? Data sources: Studies were identified by searching MEDLINE and SPORTDiscus (1966-September 2001) and by a manual search of the reference lists of retrieved articles. Study selection: Studies were selected if they were randomised controlled trials (RCTs), had follow-up of at least two weeks, the only difference between experimental and control groups was aerobic physical activity, and the paper was published in English. Data extraction: Three reviewers independently extracted data on characteristics of participants, study design, intervention method and outcomes. Disagreements were resolved by consensus. Statistical analysis: A random effects model was used to pool the overall effect size for both systolic and diastolic blood pressure. The characteristics used for subgroup analyses included hypertensive status, ethnicity, study duration, study sample size, study design, baseline BMI, weight loss during trial, exercise type, exercise frequency and exercise intensity. Main results: Fifty-four RCTs met the selection criteria: 53 provided usable systolic blood pressure data and 50 provided usable diastolic blood pressure data. Systolic blood pressure decreased in 44 of 53 trials (20 statistically significant) and diastolic blood pressure decreased in 42 of 50 trials (16 statistically significant). The overall pooled net effect of aerobic exercise on systolic and diastolic blood pressure was-3.84 mmHg (95% CI-4.97 to 2.72 mmHg) and-2.58 mmHg (95% CI-3.35 to 1.81 mmHg). Reduced blood pressure was observed in all subgroups. Conclusions: Aerobic exercise reduces blood pressure in hypertensive and normotensive persons and in those who are overweight or of normal weight. The type, frequency or intensity of aerobic exercise does not seem to influence outcome. Commentary Approximately three million adult Australians have hypertension. It is the single most common problem managed in general practice (AIHW 2002) and a major risk factor for cardiovascular disease, the most common cause of death amongst Australians. Although pharmacotherapy effectively reduces blood pressure in the hypertensive (AIHW 2002), it can be associated with deleterious side effects. Thus, the efficacies of lifestyle modifications such as increased levels of physical activity are of interest. This meta-analysis clearly demonstrates that aerobic exercise significantly reduces systolic and diastolic blood pressure in hypertensive and normotensive individuals. These beneficial effects were independent of changes in body weight. Subgroup analysis suggested the benefits occurred in all …