Date of Completion

8-21-2015

Embargo Period

8-20-2018

Keywords

Blood Pressure; Hypertension; Lifestyle Intervention; Systematic Review; Exercise Training; Meta-Analysis

Major Advisor

Linda S. Pescatello, PhD

Associate Advisor

Jeffrey Anderson, MD

Associate Advisor

Tania B. Huedo-Medina, PhD

Associate Advisor

William J. Kraemer, PhD

Associate Advisor

Blair T. Johnson, PhD

Field of Study

Kinesiology

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

The general consensus is that aerobic exercise training (AET) and dynamic resistance training (RT) lowers blood pressure (BP) 5-7 and 2-3 mmHg among adults with hypertension. However, there is significant variability in the BP response to exercise, ranging from ~0-9 mmHg. Patient and exercise characteristics may explain these differences; yet, what patient profile and exercise features elicits optimal BP benefit remains unclear. Therefore, we performed two high-quality meta-analyses to determine the effectiveness of AET and RT as stand-alone antihypertensive therapy and identify what patient profile and exercise ‘dose’ elicited optimal BP-benefit. Methods: 84 and 64 controlled AET and RT trials were analyzed following random-effects assumptions. Results: White, middle-aged, overweight adults with prehypertension that performed AET and RT ~3-4d·wk-1 for 14-18wks reduced systolic BP (SBP)/diastolic BP (DBP) ~4/3 and ~3/2 mmHg versus controls (ps<0.01). Greater BP reductions occurred among AET and RT samples with higher resting BP: ~7/6 and ~6/5 mmHg for hypertension, ~5/4 and ~3/3 mmHg for prehypertension, ~3/1 and ~0/1 mmHg for normal BP (ps≤0.03). AET reduced BP to the greatest extent among non-White samples with hypertension that achieved large fitness gains and performed high AET volume (‑12.0/-12.2 mmHg), twice the magnitude among White samples (‑6.8/-6.3 mmHg). RT reduced BP to the greatest extent among non-White samples with hypertension (‑14.3/‑10.3 mmHg). Discussion: These results highlight the critical need for more precise exercise prescriptions that maximize the effectiveness of AET and RT as viable stand-alone or combined antihypertensive therapeutic exercise options among racially/ethnically diverse samples with hypertension.

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