Effect of resistance exercise on ambulatory blood pressure: systematic review & meta-analysis

This systematic review/meta-analysis aimed to evaluate the effects of resistance exercise on ambulatory blood pressure (BP). PubMed, Web of Science, Scielo, Embase and Scopus databases were searched for crossover/controlled trials of resistance exercise in adults compared to a control group/condition from inception until May 2025. Mean differences with 95% confidence intervals were calculated (p<0.05 significant). Risk of bias was assessed by the Cochrane risk-of-bias tool for randomized trials. Twenty-six studies were included, 18 acute (immediate, short-term including 351 participants) and 8 chronic (long-term, including 356 participants), with mostly unclear/high risk of bias. Acutely resistance exercises reduced 24-hour diastolic BP in subjects with chronic diseases (-1.15mmHg; -2.08, -0.22; p=0.020), and lower daytime diastolic BP in healthy participants (-0.77mmHg, -1.51, -0.03; p=0.040). Chronically resistance training lowered 24-hour systolic (-3.99mmHg; -7.59, -0.39; p=0.030) and diastolic BP (-1.52mmHg; -2.67, -0.37; p=0.009) and daytime systolic/diastolic BP in subjects with chronic diseases (Systolic: -5.53mmHg; -8.83, -2.23; p=0.001; Diastolic: -1.86mmHg; -3.11, -0.61; p=0.003). In conclusion, resistance exercise promotes modest reductions in ambulatory blood pressure, especially among individuals with chronic diseases. The most consistent effects were observed for 24-hour and daytime systolic and diastolic BP. Acute reductions were smaller and limited to daytime diastolic BP.