Pulmonary hypertension (PH) is a complex and progressive disease associated with reduced exercise tolerance and diminished quality of life, despite advances in pharmacologic therapy. In recent years, exercise training has emerged as a potential supportive intervention, though uncertainty remains regarding its safety and clinical benefits. This systematic review and meta-analysis evaluated the impact of structured exercise programs on adults with Group 1 or Group 4 PH. A comprehensive search of PubMed and the Cochrane Library was conducted up to July 2025 to identify randomized controlled trials and non-randomized interventional studies. Key outcomes included exercise capacity (6-minute walk distance), peak oxygen uptake, quality of life, and safety. Data were pooled using a random-effects model, and study quality was assessed with validated risk of bias tools. Thirteen studies, including approximately 700 participants, were selected for review. Exercise interventions significantly improved 6MWD (mean difference: +52.5 meters) and peak oxygen uptake (+1.65 mL/kg/min), though considerable heterogeneity was observed. Changes in physical and mental quality-of-life scores were not statistically significant but trended positively. A reduction in pulmonary artery systolic pressure was noted, while resting heart rate remained unchanged. Across all studies, exercise training was consistently well-tolerated, with no serious adverse events directly linked to the interventions. Structured exercise training appears to be both effective and safe for individuals with PH, leading to measurable gains in physical performance and aerobic capacity. These findings support its integration into multidisciplinary care, with further research needed to refine protocols and broaden access through home-based or digitally supported programs.
Ιωάννης Μπέης (Wed,) studied this question.