Walking for hypertension

Lee, Ling-Ling; Mulvaney, Caroline; Wong, Yin Kwan; Chan, Edwin Sy; Watson, Michael Craig; Lin, Hui-Hsin

doi:10.1002/14651858.cd008823.pub2

Cited by 35 publications

(62 citation statements)

References 450 publications

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“…7 A recent Cochrane Database systematic review with meta-analysis of 73 randomized controlled trials that included normotensive and hypertensive participants 16 years of age and older reported that walking reduces resting SBP by 4.1 mmHg (73 studies, 5060 participants, 95% CI, −5.2, −3.0 mmHg) and resting DBP by 1.8 mmHg (69 studies, 4711 participants, 95% CI, −2.5, −1.1 mmHg). 8 No statistically significant differences were observed when results were partitioned according to age, sex, and BP status (normotensives versus hypertensives). 8 Other meta-analyses have yielded similar overall results.…”

Section: Introductionmentioning

confidence: 93%

“…8 No statistically significant differences were observed when results were partitioned according to age, sex, and BP status (normotensives versus hypertensives). 8 Other meta-analyses have yielded similar overall results. [9][10][11] The mechanisms associated with changes in resting BP, both acute and chronic, as a result of activities such as walking, include, but are not necessarily limited to, an immediate decrease in nitric oxide mediated endothelial function 12 and decreased sympathetic drive.…”

Section: Introductionmentioning

confidence: 93%

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Walking and resting blood pressure: An inter-individual response difference meta-analysis of randomized controlled trials

Kelley

Stauffer

2022

Science Progress

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Whether true inter-individual response differences (IIRD) exist with respect to walking training and chronic changes in resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults is not known. To address this gap, data from a meta-analysis representing up to 5060 normotensive and high normal/hypertensive (SBP ≥ 130 and/or DBP ≥ 85 mmHg) participants 16 to 84 years of age (2881 walking, 2179 control) nested in 73 randomized controlled trials were included. Walking and control group change outcome standard deviations treated as point estimates for both resting SBP and DBP were used to calculate true IIRD from each study. The inverse variance heterogeneity (IVhet) model was used to pool IIRD as well as traditional pairwise results. Both 95% confidence intervals (CI) and prediction intervals (PI) were calculated. While statistically significant reductions in resting SBP ([Formula: see text], −3.9 mmHg, 95% CI, −5.4 to −2.3 mmHg) and DBP ([Formula: see text], −1.4 mmHg, 95% CI, −2.5 to −0.3 mmHg) were found, true IIRD were neither statistically significant nor clinically important for both SBP ([Formula: see text], −1.4 mmHg, 95% CI, −2.0 to 2.8 mmHg) and DBP ([Formula: see text], 0.9 mmHg, 95% CI, −2.5 to 2.8 mmHg). The 95% prediction interval for true IIRD was −2.1 to 2.8 mmHg for SBP and −3.2 to 3.4 mmHg for DBP. Conclusions While walking is associated with reductions in resting SBP and DBP, a lack of true IIRD exists, suggesting that factors other than training response variation (random variation, physiological responses associated with behavioral changes that are not the result of walking) are responsible for the observed variation in resting SBP and DBP.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 93%

Walking and resting blood pressure: An inter-individual response difference meta-analysis of randomized controlled trials

Kelley

Stauffer

2022

Science Progress

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“…Modifying health-related behaviors to address the underlying risk factors of hypertension could result in clinically significant health improvements and reduce morbidity, mortality, and treatment cost. Practitioners have an important role in prescribing lifestyle modifications; however, the time they can spend providing advice about and supporting adherence to health behavior change recommendations is limited and expensive [ 13 ], and there is currently limited evidence on effective interventions to support health behavior change in patients treated for hypertension [ 14 - 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Association Between Smartphone App–Based Self-monitoring of Hypertension-Related Behaviors and Reductions in High Blood Pressure: Systematic Review and Meta-analysis

Kassavou¹,

Wang²,

Mirzaei³

et al. 2022

JMIR Mhealth Uhealth

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Background Self-monitoring of behavior can support lifestyle modifications; however, we do not know whether such interventions are effective in supporting positive changes in hypertension-related health behaviors and thus in reducing blood pressure in patients treated for hypertension. Objective This systematic literature review evaluates the extent to which smartphone app–based self-monitoring of health behavior supports reductions in blood pressure and changes in hypertension-related behaviors. It also explores the behavioral components that might explain intervention effectiveness. Methods A systematic search of 7 databases was conducted in August 2021. Article screening, study and intervention coding, and data extraction were completed independently by reviewers. The search strategy was developed using keywords from previous reviews and relevant literature. Trials involving adults, published after the year 2000, and in the English language were considered for inclusion. The random-effects meta-analysis method was used to account for the distribution of the effect across the studies. Results We identified 4638 articles, of which 227 were included for full-text screening. A total of 15 randomized controlled trials were included in the review. In total, 7415 patients with hypertension were included in the meta-analysis. The results indicate that app-based behavioral self-monitoring interventions had a small but significant effect in reducing systolic blood pressure (SBP), on average, by 1.64 mmHg (95% CI 2.73-0.55, n=7301; odds ratio [OR] 1.60, 95% CI 0.74-3.42, n=114) and in improving changes in medication adherence behavior (standardized mean difference [SMD] 0.78, 95% CI 0.22-1.34) compared to usual care or minimal intervention. The review found the intervention had a small effect on supporting improvements in healthy diet by changing habits related to high sodium food (SMD –0.44, 95% CI –0.79 to –0.08) and a trend, although insignificant, toward supporting smoking cessation, low alcohol consumption, and better physical activity behaviors. A subgroup analysis found that behavioral self-monitoring interventions combined with tailored advice resulted in higher and significant changes in both SBP and diastolic blood pressure (DBP) in comparison to those not providing tailored advice (SBP: –2.92 mmHg, 95% CI –3.94 to –1.90, n=3102 vs –0.72 mmHg, 95% CI –1.67 to 0.23, n=4199, χ2=9.65, P=.002; DBP: –2.05 mmHg, 95% CI –3.10 to –1.01, n=968 vs 1.54 mmHg, 95% CI –0.53 to 3.61, n=400, χ2=9.19, P=.002). Conclusions Self-monitoring of hypertension-related behaviors via smartphone apps combined with tailored advice has a modest but potentially clinically significant effect on blood pressure reduction. Future studies could use rigorous methods to explore its effects on supporting changes in both blood pressure and hypertension-related health behaviors to inform recommendations for policy making and service provision. Trial Registration PROSPERO CRD42019136158; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136158

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“…25 , 26 A meta‐analysis published in 2021 had evidence of moderate certainty that walking reduces at least systolic BP for all ages and both sexes, and that it may also reduce diastolic BP. 27 …”

Section: Discussionmentioning

confidence: 99%

Underuse of lifestyle recommendations in hypertension management in France: The Esteban study

Vay-Demouy

Lelong

Neudorff

et al. 2022

J of Clinical Hypertension

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Lifestyle recommendations are first-line elements in the management of arterial hypertension. This cross-sectional study aimed to analyze the level to which lifestyle recommendations are used in hypertension management in France, using data from the Esteban study, which was implemented by Santé Publique France, France's public health agency, from 2014 to 2016 on a representative sample of the French population. The study sample comprised 440 adult Esteban participants who were aware they had hypertension and were aged 18-74 years old. The main outcomes were the proportion of participants who received lifestyle recommendations in their hypertension management plan, and the proportion of recommendations according to the three following dimensions: physical activity, weight loss, and changes in diet. Over half (57.0%) of the 440 participants declared they did not receive lifestyle recommendations as part of their hypertension management plan in the year preceding the study.Of these, 39.0% did not receive pharmacological treatment either. Physical activity was recommended to 31.8% of sedentary participants and weight loss to 26.8% of participants with overweight or obesity. One-fifth of the study sample (20.1%) received dietary recommendations. Of these, 69% and 10.7% were advised to limit their salt and alcohol intake, respectively. Lifestyle interventions are too rarely recommended in hypertension management plans in France. Adherence to lifestyle recommendations needs in-depth discussion not only at the time of diagnosis but also throughout follow-up.

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Walking for hypertension

Cited by 35 publications

References 450 publications

Walking and resting blood pressure: An inter-individual response difference meta-analysis of randomized controlled trials

Walking and resting blood pressure: An inter-individual response difference meta-analysis of randomized controlled trials

The Association Between Smartphone App–Based Self-monitoring of Hypertension-Related Behaviors and Reductions in High Blood Pressure: Systematic Review and Meta-analysis

Underuse of lifestyle recommendations in hypertension management in France: The Esteban study

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