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ARTICLE

Effect of Aerobic Exercise on Blood Pressure

A Meta-Analysis of Randomized, Controlled Trials

right arrow Seamus P. Whelton; Ashley Chin, MPH, MA; Xue Xin, MD, MS; and Jiang He, MD, PhD

2 April 2002 | Volume 136 Issue 7 | Pages 493-503

Purpose: Physical activity has been associated with reduced blood pressure in observational epidemiologic studies and individual clinical trials. This meta-analysis of randomized, controlled trials was conducted to determine the effect of aerobic exercise on blood pressure.

Data Sources: English-language articles published before September 2001.

Study Selection: 54 randomized, controlled trials (2419 participants) whose intervention and control groups differed only in aerobic exercise.

Data Extraction: Using a standardized protocol and data extraction form, three of the investigators independently abstracted data on study design, sample size, participant characteristics, type of intervention, follow-up duration, and treatment outcomes.

Data Synthesis: In a random-effects model, data from each trial were pooled and weighted by the inverse of the total variance. Aerobic exercise was associated with a significant reduction in mean systolic and diastolic blood pressure (–3.84 mm Hg [95% CI, –4.97 to –2.72 mm Hg] and –2.58 mm Hg [CI, –3.35 to –1.81 mm Hg], respectively). A reduction in blood pressure was associated with aerobic exercise in hypertensive participants and normotensive participants and in overweight participants and normal-weight participants.

Conclusions: Aerobic exercise reduces blood pressure in both hypertensive and normotensive persons. An increase in aerobic physical activity should be considered an important component of lifestyle modification for prevention and treatment of high blood pressure.


Editors' Notes
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Context

  • Exercise can lower blood pressure, but by how much and in whom?

Contribution

  • This meta-analysis of 54 trials showed that previously sed-entary adults could decrease systolic blood pressure by 3.8 mm Hg (95% CI, 2.7 to 5.0 mm Hg) and diastolic blood pressure by 2.6 mm Hg (CI, 1.8 to 3.4 mm Hg) with regu-lar aerobic exercise.
  • Exercise lowered blood pressure in people who were normotensive or hypertensive; overweight or of normal weight; and black, white, or Asian.
  • All frequencies, intensities, and types of aerobic exercise lowered blood pressure.

Cautions

  • Trials lasting longer than 6 months showed smaller reduc-tions in blood pressure, perhaps because of difficulties in sustaining regular exercise.

–The Editors

 

Author and Article Information
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From Tulane University, New Orleans, Louisiana.

Grant Support: By the National Heart, Lung, and Blood Institute, National Institutes of Health (R01HL60300).

Requests for Single Reprints: Jiang He, MD, PhD, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112; e-mail, jhe{at}tulane.edu.

Current Author Addresses: Mr. Whelton: Princeton University, Mailbox 2162, Princeton, NJ 08544.

Ms. Chin and Dr. He: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112.

Dr. Xin: Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112.

Author Contributions: Conception and design: S.P. Whelton, A. Chin, J. He.

Analysis and interpretation of the data: S.P. Whelton, A. Chin, X. Xin, J. He.

Drafting of the article: S.P. Whelton, J. He.

Critical revision of the article for important intellectual content: S.P. Whelton, A. Chin, X. Xin, J. He.

Final approval of the article: S.P. Whelton, A. Chin, X. Xin, J. He.

Provision of study materials or patients: S.P. Whelton, X. Xin.

Statistical expertise: X. Xin, J. He.

Obtaining of funding: J. He.

Collection and assembly of data: S.P. Whelton, A. Chin, X. Xin, J. He.

 

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J. E. Neter, B. E. Stam, F. J. Kok, D. E. Grobbee, and J. M. Geleijnse
Influence of Weight Reduction on Blood Pressure: A Meta-Analysis of Randomized Controlled Trials
Hypertension, November 1, 2003; 42(5): 878 - 884.
[Abstract] [Full Text] [PDF]


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J. Am. Soc. Nephrol.Home page
L. J. Appel
Lifestyle Modification as a Means to Prevent and Treat High Blood Pressure
J. Am. Soc. Nephrol., July 1, 2003; 14(90002): S99 - 102.
[Abstract] [Full Text] [PDF]


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JAMAHome page
A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr, D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright Jr, et al.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report
JAMA, May 21, 2003; 289(19): 2560 - 2571.
[Abstract] [Full Text] [PDF]


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Diabetes CareHome page
L. E. Egede
Lifestyle Modification to Improve Blood Pressure Control in Individuals With Diabetes: Is physician advice effective?
Diabetes Care, March 1, 2003; 26(3): 602 - 607.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
T. Kimura, T. Yokoyama, Y. Matsumura, N. Yoshiike, C. Date, M. Muramatsu, and H. Tanaka
NOS3 Genotype-Dependent Correlation Between Blood Pressure and Physical Activity
Hypertension, February 1, 2003; 41(2): 355 - 360.
[Abstract] [Full Text] [PDF]


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Evid. Based Nurs.Home page
OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02)
Evid. Based Nurs., January 1, 2003; 6(1): e1 - 1.
[Full Text] [PDF]


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NEJMHome page
K. J. Stewart, W. R. Hiatt, J. G. Regensteiner, and A. T. Hirsch
Exercise Training for Claudication
N. Engl. J. Med., December 12, 2002; 347(24): 1941 - 1951.
[Full Text] [PDF]


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Evid. Based Med.Home page
C. R. Elley and B. Arroll
Review: aerobic exercise reduces systolic and diastolic blood pressure in adults
Evid. Based Med., November 1, 2002; 7(6): 170 - 170.
[Full Text] [PDF]


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JAMAHome page
P. K. Whelton, J. He, L. J. Appel, J. A. Cutler, S. Havas, T. A. Kotchen, E. J. Roccella, R. Stout, C. Vallbona, M. C. Winston, et al.
Primary Prevention of Hypertension: Clinical and Public Health Advisory From the National High Blood Pressure Education Program
JAMA, October 16, 2002; 288(15): 1882 - 1888.
[Abstract] [Full Text] [PDF]


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JAMAHome page
K. J. Stewart
Exercise Training and the Cardiovascular Consequences of Type 2 Diabetes and Hypertension: Plausible Mechanisms for Improving Cardiovascular Health
JAMA, October 2, 2002; 288(13): 1622 - 1631.
[Abstract] [Full Text] [PDF]


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BMJHome page
G D. Batty and I-M. Lee
Physical activity for preventing strokes
BMJ, August 17, 2002; 325(7360): 350 - 351.
[Full Text] [PDF]


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Journal Watch CardiologyHome page
How Much Does Exercise Lower BP?
Journal Watch Cardiology, April 26, 2002; 2002(426): 5 - 5.
[Full Text]




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