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Endurance exercise beneficially affects ambulatory blood pressure: a systematic review and meta-analysis

Cornelissen, Véronique A.a,b; Buys, Roseliena; Smart, Neil A.b

doi: 10.1097/HJH.0b013e32835ca964

Exercise is widely recommended as one of the key preventive lifestyle changes to reduce the risk of hypertension and to manage high blood pressure (BP), but individual studies investigating the effect of exercise on ambulatory BP have remained inconclusive. Therefore, the primary purpose of this systematic review and meta-analysis was to determine the effect of aerobic endurance training on daytime and night-time BP in healthy adults. A systematic literature search was conducted using PubMed and Cochrane Controlled Clinical trial registry from their inception to May 2012. Randomized controlled trials of at least 4 weeks investigating the effects of aerobic endurance training on ambulatory BP in healthy adults were included. Inverse weighted random effects models were used for analyses, with data reported as weighted means and 95% confidence limits. We included 15 randomized controlled trials, involving 17 study groups and 633 participants (394 exercise participants and 239 control participants). Overall, endurance training induced a significant reduction in daytime SBP [−3.2 mmHg, 95% confidence interval (CI), −5.0 to−1.3] and daytime DBP (−2.7 mmHg, 95% CI, −3.9 to −1.5). No effect was observed on night-time BP. The findings from this meta-analysis suggest that aerobic endurance exercise significantly decreases daytime, but not night-time, ambulatory BP.

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aDepartment of Rehabilitation Sciences, Research Center for Cardiovascular Rehabilitation, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium

bSchool of Science and Technology, University of New England, Armidale, New South Wales, Australia

Correspondence to Véronique A. Cornelissen, Faculty of Kinesiology and Rehabilitation Sciences, Tervuursevest 101 B 1501, 3001 Leuven, Belgium. Tel: +321 632 9023; e-mail:

Abbreviations: ABP, ambulatory blood pressure; BP, blood pressure; CI, confidence interval; HRmax, maximal heart rate; HRres, heart rate reserve; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; US, United States; VO2 peak, peak oxygen uptake

Received 13 September, 2012

Revised 15 October, 2012

Accepted 15 November, 2012

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© 2013 Lippincott Williams & Wilkins, Inc.