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Funding Acknowledgements Type of funding sources: None. Background Worldwide, raised blood pressure (BP) or hypertension (HT) is the global leading risk factor for the development of cardiovascular diseases and all-cause mortality, with the highest prevalence found in Asian and African-origin populations. Post-exercise hypotension (PEH) defined as a sustained reduction in BP after a single bout of exercise is an important physiological phenomenon in BP management which can last up to 24 hours. However, little is known about the hypotensive effect of a single bout of exercise in non-Caucasian populations. Objectives To systematically summarize the acute effects of a single bout of aerobic exercise on blood pressure in a population of African or Asian origin. Methods We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations with optimal BP, high normal BP or HT published in a peer reviewed journal up to August 2021. A subsequent meta-analysis was performed using random effect models fitted to estimate effect sizes. Results We identified 10 aerobic exercise trials of individuals of Asian origin (n= 156; mean age: 27.05 years: 72% male; baseline SBP/DBP: 114.93 [99,142] / 67.34 [61,74] mmHg) and 11 aerobic exercise trials involving individuals of African origin (n=112; mean age: 41.37 years; 62% male; baseline SBP/DBP: 125.77 [106.6,140.2] / 79.72 [69.9, 84.3] mmHg). Non-significant moderate reductions in office SBP and DBP at 30 minutes postexercise (-2.25 [-6.38, 1.88] mmHg, p = 0.28 / -1.02 [-2.51, 0.47] mmHg, p = 0.18) and 60 minutes postexercise (-2.80 [-7.90, 2.28], p = 0.27 / -1.95, [-5.66, 1.75], p = 0.3) were observed compared to control group. No statistically significant differences were found between ethnic groups (p > 0.05). Ambulatory BP was reported only in the African groups. No effect was found on 24h-SBP post-exercise, but 24h-DBP was statistically signficantly reduced (-1.89 [-3.47, -0.31] mmHg, p < 0.01) after a bout of aerobic exercise. Conclusions A single bout of aerobic exercise did not significantly reduce BP immediately in the African and Asian group. In the African group a small though statistically significant lower 24h-DBP was observed. Unfortunately, no data was found on the 24h-BP response in Asians. The low number of studies in both ethnic groups and lack of data on isometric and resistance exercise in African and Asian populations warrant more research to improve quality of evidence.

Objective:Hypertension is the global leading risk factor for the development of cardiovascular diseases, with the highest prevalence in Asian and African populations. Post-exercise hypotension (PEH) defined as a sustained reduction in blood pressure (BP) after a single bout of exercise is an important physiological phenomenon in BP management. However, little is known about PEH in non-Caucasian populations.Therefore, we aim to systematically summarize the effects of a single bout of aerobic exercise on BP in non-Caucasian populations.Design and method:We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations published in a peer reviewed journal up to August 2021. A meta-analysis was performed to estimate random effect sizes within 95% of confidence intervals.Results:We identified 10 aerobic exercise trials in individuals of Asian origin (n = 156; mean age: 27.05 years: 72% male) and 11 aerobic exercise trials involving individuals of African origin (n = 112; mean age: 41.37 years; 62% male). Non-significant reductions in office BP at 30 minutes (-1.18 [-9.98, 7.62]/-1.29 [-7.32, 4.74] mmHg) and 60 minutes postexercise (-1.80 [-9.98, 7.62]/ -1.28 [-6.03, 3.46] mmHg) were observed in the African group. Similar to the African group, non-significant reductions in office BP at 30 minutes (-2.17 [-6.78, 2.43] / -0.82 [-2.41, 0.77] mmHg) postexercise were observed in the Asian group. No effect was found on 24h-systolic BP postexercise, but 24h-diastolic BP reduced significantly (-1.89 [-3.47, -0.31] mmHg) in the African group.Conclusions:Except for a small, though statistically significant effect on 24h-DBP in the African group, a single bout of aerobic exercise does not seem to cause clinically relevant PEH in the African and Asian populations. It should be acknowledged that the available studies on PEH applying aerobic exercise are limited and there is a lack of data on PEH following isometric and resistance exercise in these populations. This systematic review and meta-analysis is a call for more research on exercise therapy in non-Caucasians.