Effects of exercise-related interventions on blood pressure and related variables among individuals with hypertension: a systematic review and meta-analysis
5 affiliations
- 1Physiotherapy Department, Federal University of Health Sciences Azare
- 2Department of Allied Health Professions, School of Health and Life Sciences, Glasgow Caledonian University
- 3Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University
- 4Department of Community, Psychiatric and Mental Health Nursing, College of Nursing, Qassim University
- 5Department of Medicine, Federal University Dutse
Abstract
Background: Hypertension is a leading contributor to global cardiovascular disease burden and premature mortality. Although pharmacological treatment is effective, long-term Blood Pressure (BP) control remains suboptimal for many patients, highlighting the importance of non-pharmacological strategies such as physical exercise. This systematic review and meta-analysis aimed to evaluate the effectiveness of exercise training interventions for improving BP outcomes among adults with hypertension. While a limited number of included randomized controlled trials involved participants with prehypertension, the review primary focus was hypertension management.
Methods: A systematic literature search was conducted across five electronic databases (Scopus, AMED, MEDLINE, PUBMED, and CINAHL) to identify relevant clinical trials. A small number of trials involving participants with prehypertension or stage 1 hypertension were retained where they met the predefined eligibility criteria and contributed to the overall evidence regarding elevated BP management. Methodological quality of the included studies was assessed using the PEDro scale. Data were synthesized using random-effects meta-analysis, and pooled effects were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Statistical heterogeneity was evaluated using the I ² statistic. Meta-analyses were conducted using Review Manager 5. Structured Narrative synthesis was performed where meta-analysis was not feasible.
Results: A total of 26 studies that recruited 1,576 participants met the inclusion criteria and were included in the review. Majority of the studies were of moderate-to-good methodological quality (∼70%). Aerobic training consistently produced statistically significant and clinically meaningful reductions in both SBP (SMD: −0.97; 95% CI −1.46 to −0.47; p = 0.0001) and DBP (SMD: −1.55; 95% CI −2.19 to −0.90; p < 0.00001). Combined aerobic and resistance training also resulted in significant reductions in SBP (SMD: −1.11; 95% CI: −2.11 to −0.11; p = 0.03) and DBP (SMD: −1.25; 95% CI: −2.24 to −0.27; p = 0.01), suggesting potential additive or complementary effects of multimodal exercise interventions. Resistance training alone demonstrated a significant and large reduction in DBP but showed inconsistent and non-significant effects on SBP. In addition to blood pressure reduction, several studies reported improvements in secondary outcomes, including cardiorespiratory fitness, heart rate variability, body composition, inflammatory markers, physical performance, and quality of life. However, substantial between-study heterogeneity was observed across most pooled analyses, warranting cautious interpretation of the findings.
Conclusion: The available evidence suggests that aerobic exercise, either alone or combined with resistance training, is associated with some beneficial reductions in systolic and diastolic blood pressure among individuals with hypertension.
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BibTeX
@article{bappah2026effects,
title = {{Effects of exercise-related interventions on blood pressure and related variables among individuals with hypertension: a systematic review and meta-analysis}},
author = {Babangida Shehu Bappah and Umar Muhammad Bello and Aisha Shittu and Lawan Umar and Suleiman Mohammed and Buhari Abdullahi Tafida and Adamu Usman Gamawa and Ismail Idris and Zainab Umar Dahiru and Asmau Ahmad Tijjani and Dauda Salihu and Sabiu Hamza Muhammad and Jibril Mohammed Nuhu and Isah Usman Lawal and Jibril Mohammed},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1908252},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1908252/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of exercise-related interventions on blood pressure and related variables among individuals with hypertension: a systematic review and meta-analysis
AU - Babangida Shehu Bappah
AU - Umar Muhammad Bello
AU - Aisha Shittu
AU - Lawan Umar
AU - Suleiman Mohammed
AU - Buhari Abdullahi Tafida
AU - Adamu Usman Gamawa
AU - Ismail Idris
AU - Zainab Umar Dahiru
AU - Asmau Ahmad Tijjani
AU - Dauda Salihu
AU - Sabiu Hamza Muhammad
AU - Jibril Mohammed Nuhu
AU - Isah Usman Lawal
AU - Jibril Mohammed
PY - 2026
DA - 2026/10/13
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1908252
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1908252/full
AB - Background: Hypertension is a leading contributor to global cardiovascular disease burden and premature mortality. Although pharmacological treatment is effective, long-term Blood Pressure (BP) control remains suboptimal for many patients, highlighting the importance of non-pharmacological strategies such as physical exercise. This systematic review and meta-analysis aimed to evaluate the effectiveness of exercise training interventions for improving BP outcomes among adults with hypertension. While a limited number of included randomized controlled trials involved participants with prehypertension, the review primary focus was hypertension management. Methods: A systematic literature search was conducted across five electronic databases (Scopus, AMED, MEDLINE, PUBMED, and CINAHL) to identify relevant clinical trials. A small number of trials involving participants with prehypertension or stage 1 hypertension were retained where they met the predefined eligibility criteria and contributed to the overall evidence regarding elevated BP management. Methodological quality of the included studies was assessed using the PEDro scale. Data were synthesized using random-effects meta-analysis, and pooled effects were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Statistical heterogeneity was evaluated using the I ² statistic. Meta-analyses were conducted using Review Manager 5. Structured Narrative synthesis was performed where meta-analysis was not feasible. Results: A total of 26 studies that recruited 1,576 participants met the inclusion criteria and were included in the review. Majority of the studies were of moderate-to-good methodological quality (∼70%). Aerobic training consistently produced statistically significant and clinically meaningful reductions in both SBP (SMD: −0.97; 95% CI −1.46 to −0.47; p = 0.0001) and DBP (SMD: −1.55; 95% CI −2.19 to −0.90; p < 0.00001). Combined aerobic and resistance training also resulted in significant reductions in SBP (SMD: −1.11; 95% CI: −2.11 to −0.11; p = 0.03) and DBP (SMD: −1.25; 95% CI: −2.24 to −0.27; p = 0.01), suggesting potential additive or complementary effects of multimodal exercise interventions. Resistance training alone demonstrated a significant and large reduction in DBP but showed inconsistent and non-significant effects on SBP. In addition to blood pressure reduction, several studies reported improvements in secondary outcomes, including cardiorespiratory fitness, heart rate variability, body composition, inflammatory markers, physical performance, and quality of life. However, substantial between-study heterogeneity was observed across most pooled analyses, warranting cautious interpretation of the findings. Conclusion: The available evidence suggests that aerobic exercise, either alone or combined with resistance training, is associated with some beneficial reductions in systolic and diastolic blood pressure among individuals with hypertension.
SN - 2297-055X
ER -