Optimal exercise modalities and doses for blood pressure management in adults with prehypertension and hypertension: A systematic review and Bayesian network meta-analysis.
Yuan Yuan, Bopeng Qiu, Yumi Park et al.
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In 30 seconds
This systematic review and Bayesian network meta-analysis compared structured exercise modalities and estimated doses for blood pressure reduction in adults with prehypertension or stage 1 or 2 hypertension. It included 284 randomised controlled trials with 18,750 participants (mean age 56.8 years). Aquatic exercise had the largest estimated systolic reduction (mean difference −10.28 mmHg; 95% credible interval −13.05 to −7.49), while mind-body exercise had the largest estimated diastolic reduction (−4.69 mmHg; 95% credible interval −6.45 to −2.92). Dose-response models also identified modality-specific doses associated with maximal modeled benefit.
Key findings
- Aquatic exercise ranked highest for systolic blood pressure reduction: mean difference −10.28 mmHg (95% credible interval −13.05 to −7.49).
- Mind-body exercise had the largest estimated diastolic reduction: mean difference −4.69 mmHg (95% credible interval −6.45 to −2.92).
- For isometric training, 750 metabolic equivalent task minutes per week was associated with maximal modeled systolic benefit: −13.52 mmHg (95% credible interval −23.22 to −3.86).
- For aerobic exercise, 3600 metabolic equivalent task minutes per week was associated with maximal modeled diastolic benefit: −7.11 mmHg (95% credible interval −11.89 to −2.18).
Why it matters
The analysis suggests that blood pressure responses may differ by exercise modality and that estimated dose-response patterns are not uniform across modalities or systolic and diastolic outcomes. This can help frame exercise as a potentially tailored component of blood pressure management, while the comparative estimates and modeled doses should be interpreted in light of the underlying trial evidence.
What to keep in mind
The reported dose-response values are modeled estimates from a network meta-analysis, not direct evidence that these doses are optimal for every patient or hypertension phenotype.