Intermittent high-intensity exercise for pre- to established hypertension: a systematic review and meta-analysis

Scand J Med Sci Sports. 2022 Dec 29. doi: 10.1111/sms.14299. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the impact of intermittent high-intensity exercise training ([IHIE], including high-intensity interval training [HIIT] and recreational team sports [RTS]) on systolic (SBP) and diastolic blood pressure (DBP) in adults with pre- to established arterial hypertension.

DATA SOURCES: MEDLINE, Cochrane Library, Embase and SPORTDiscus.

ELIGIBILITY CRITERIA: Randomized controlled trials (RCTs) comparing the impact of IHIE on BP versus a non-exercise control.

DATA COLLECTION AND ANALYSIS: Two authors independently conducted all procedures. Mean differences were calculated using random-effects model. The certainty of the evidence was assessed with GRADE.

RESULTS: Twenty-seven RCTs (18 HIIT and 9 RTS) were analyzed, with median duration of 12 weeks. Participants’ (n=946) median age was 46 years. Overall, IHIE decreased SBP (-3.29 mmHg; 95%CI: -5.19, -1.39) and DBP (-2.62 mmHg; 95%CI: -3.79, -1.44) compared to the control group. IHIE elicited higher decreases in office SBP and DBP of hypertensive subjects (SBP: -7.13 mmHg; [95%CI: -10.12, -4.15]; DBP: -5.81 mmHg, [95%CI: -7.94, -3.69]) than pre-hypertensive (SBP: -2.14 mmHg, [95%CI: -4.36, -0.08]; DBP: -1.83 mmHg, [95%CI: -2.99, -0.67]). No significant differences were found between HIIT (SBP: -2.12 mmHg, [95%CI: -4.78, -0.54]; DBP: -1.89 mmHg, [95%CI: -3.32, -0.48]) and RTS (SBP: -4.18 mmHg, [95%CI: -7.19, -2.43]; DBP: -4.04 mmHg, [95%CI: -6.00, -2.09]). These findings are low/very low certainty of evidence. No adverse cardiovascular events were reported.

CONCLUSIONS: IHIE appears to be safe and to promote substantial decreases in BP, particularly in patients with hypertension. However, the certainty of evidence was low/very low.

PMID:36579740 | DOI:10.1111/sms.14299

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