Effects of Endurance Training on Blood Pressure, Blood Pressure–Regulating Mechanisms, and Cardiovascular Risk Factors

Abstract

Abstract-Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure-regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of Ն4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm Hg (PϽ0.001) and 3.3/3.5 mm Hg (PϽ0.01). The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (Ϫ6.9/Ϫ4.9) than in the others (Ϫ1.9/Ϫ1.6; PϽ0.001 for all). Systemic vascular resistance decreased by 7.1% (PϽ0.05), plasma norepinephrine by 29% (PϽ0.001), and plasma renin activity by 20% (PϽ0.05). Body weight decreased by 1.2 kg (PϽ0.001), waist circumference by 2.8 cm (PϽ0.001), percent body fat by 1.4% (PϽ0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U (PϽ0.01); HDL cholesterol increased by 0.032 mmol/L Ϫ1 (PϽ0.05). In conclusion, aerobic endurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors. Key Words: exercise Ⅲ blood pressure Ⅲ risk factors R egular physical activity is considered a cornerstone in the prevention and management of hypertension. 1-3 Epidemiological studies indicate that greater physical activity or fitness is associated with a lower blood pressure (BP), and meta-analyses of randomized controlled trials have shown that chronic dynamic aerobic endurance training is able to reduce BP. 3 Previous meta-analyses, including the most recent ones, 4 -6 focused on resting BP and did not report on other outcomes, such as ambulatory BP monitoring (ABPM), mechanisms to explain the BP-lowering effect of exercise, and the influence on concomitant risk factors. The number of eligible randomized controlled trials and study groups has since substantially increased, which allows a more precise estimate of the overall effect of exercise training, more powerful subgroup analyses, and analyses of the determinants of the response. Moreover, a number of studies reported on ambulatory BP, BP-regulating mechanisms, and other cardiovascular risk factors. Therefore, the main aims of the current meta-analysis were to examine the influence of chronic dynamic aerobic endura...

Beta-blockers do not impair the cardiovascular benefits of endurance training in hypertensives

“…The reduction of resting BP was more pronounced in the hypertensive study groups (À6.9/À4.9 mm Hg) than in others (À1.9/À1.6 mm Hg). 3 Compared with these data, our results reveal even higher reductions of BP, indicating an efficient training concept. As reflected by the increase of FMD, the decrease of BP is associated with an improvement of endothelial function.…”

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Is weight loss the optimal target for obesity-related cardiovascular disease risk reduction?

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