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Effect of Aerobic Exercise on Blood Pressure: A Meta-Analysis of Randomized, Controlled Trials

Seamus P. Whelton; Ashley Chin, MPH, MA; Xue Xin, MD, MS; and Jiang He, MD, PhD
[+] Article and Author Information

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@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.


Ann Intern Med. 2002;136(7):493-503. doi:10.7326/0003-4819-136-7-200204020-00006
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High blood pressure is a major risk factor for stroke, coronary heart disease, congestive heart failure, and end-stage renal disease (24). While antihypertensive treatment trials have shown that pharmacologic intervention reduces the risk for cardiovascular and renal disease, concerns have also been raised about the potential for deleterious side effects of antihypertensive drugs (5455). As a result, interest in lifestyle modification, including aerobic exercise for the treatment and prevention of hypertension, has increased. Several narrative reviews and meta-analyses have examined the relationship between exercise and blood pressure (69). However, previous publications have not systematically reviewed the totality of available evidence and have not explored the influence of important covariables (such as characteristics of study participants, study design, and intervention programs) on change in systolic and diastolic blood pressure.

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Figure 2.
Average net change in systolic blood pressure and corresponding 95% CIs related to aerobic exercise intervention in 53 randomized, controlled trials.(34)

Data on systolic blood pressure were not available in 1 trial . Net change was calculated as the difference between the follow-up and baseline blood pressure levels for the intervention and control groups (parallel and factorial trials) or the difference in blood pressure levels at the end of the intervention and control treatment periods (crossover and Latin-square trials). The overall effect represents a pooled estimate obtained by summing the average net change for each trial, weighted by the inverse of its variance.

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Figure 3.
Average net change in diastolic blood pressure and corresponding 95% CIs related to aerobic exercise intervention in 50 randomized, controlled trials.(12, 15, 43)

Data on diastolic blood pressure were not available in 4 trials . Net change was calculated as the difference between the follow-up and baseline blood pressure levels for the intervention and control groups (parallel and factorial trials) or the difference in blood pressure levels at the end of the intervention and control treatment periods (crossover and Latin-square trials). The overall effect represents a pooled estimate obtained by summing the average net change for each trial, weighted by the inverse of its variance.

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Summary for Patients

Exercise Lowers Blood Pressure

The summary below is from the full report titled “Effect of Aerobic Exercise on Blood Pressure: A Meta-Analysis of Randomized, Controlled Trials.” It is in the 2 April 2002 issue of Annals of Internal Medicine (volume 136, pages 493-503). The authors are SP Whelton, A Chin, X Xin, and J He. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.

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