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.