The Immediate and Long Lasting Effects of Aerobic Exercise: A Meta-Analysis among Ethnically Diverse Adults

Date of Completion

January 2012

Keywords

Health Sciences, Public Health

Degree

Ph.D.

Abstract

Introduction: Nearly 74.5 million (25%) adults in the United States have hypertension (HTN). HTN disproportionately affects non-Hispanic blacks. Exercise is recommended as an antihypertensive lifestyle therapy. Therefore, the purposes of this meta-analysis were: To explore the efficacy of: aerobic exercise training as an antihypertensive lifestyle therapy among non-Hispanic blacks and acute aerobic exercise among ethnically diverse adults. Methods: A systematic search was conducted in PubMed to locate relevant studies using terms related to blood pressure (BP), exercise, randomized trial, and non-Hispanic black. Studies included adults 19y+; had a non-exercise, non-diet control or comparison group; reported pre- and post-intervention BP measurement; and specified the dose of the aerobic exercise intervention. Analyses incorporated random-effects assumptions. Results: In the first study, nine studies met the inclusion criteria yielding 10 interventions (exercise n=133, control n= 98). Participants were 33.6±11.3yr, overweight (29.4+ 5.1kg·m-2), and had pre-HTN [Systolic BP 122.2±11.5/Diastolic BP 76.2±9.6 mm Hg]. Interventions were performed at vigorous intensity (6.8±1.5 METs) for 39.3±11.6 min·session-1, 3.5±1.1 d·wk-1 for 12.3±5.6 wk. Exercise exhibited moderate reductions in SBP (d=-0.64, 95% CI: -1.2, -0.12; I2= 77.4%; -8.3 mm Hg, p < 0.001) and DBP (d=-0.58, 95% CI: -1.01, -0.14; I2 = 56.1%; -5.1 mm Hg, p < 0.02). In the second study, 48 trials met the inclusion criteria yielding 101 interventions (exercise n=1878 control n= 1952). Participants were 39.1±3.5yr, overweight (26.8±2.8kg/m2), and had pre-HTN [SBP 131.2±15.7/DBP 81.7±9.4 mm Hg]. Interventions were performed at vigorous intensity (6.0±2.3 METs) for 32.1±10.4min·session -1. Exercise exhibited small reductions in SBP (d=-0.25, 95% CI: -0.43, -0.09; I2 =68.7%; -1.7 mm Hg, p < 0.001) and DBP (d=-0.36, 95% CI: -0.52, -0.20; I2= 62.5%; -3.8 mm Hg, p < 0.001) measured in the laboratory; and measured throughout the day SBP ( d=-0.43, 95% CI: -0.71, -0.16; I2 =85.0%; -4.0 mm Hg, p < 0.001) and DBP (d=-0.28, 95% CI: -0.41, -0.15; I2= 0.0%; -3.5 mm Hg, p < 0.001). Important moderators included resting BP, age, and study quality. Discussion: The findings indicate acute and chronic aerobic exercise is efficacious antihypertensive lifestyle therapy, particularly for non-Hispanic blacks and under ambulatory conditions. ^

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