Effect of exercise on vascular function in hypertension patients: A meta-analysis of randomized controlled trials

Objective The purpose of this study was to systematically evaluate the effect of exercise on vascular function in patients with pre- and hypertension. Methods A systematic review of articles retrieved via the PubMed, Embase, EBSCO, and Web of Science databases was conducted. All the randomized controlled trials published between the establishment of the databases and October 2022 were included. Studies that evaluated the effects of exercise intervention on vascular function in patients with pre- and hypertension were selected. Results A total of 717 subjects were included in 12 randomized controlled trials. The meta-analysis showed that in patients with pre- and hypertension, exercise can significantly reduce systolic blood pressure (SBP) ( MD = –4.89; 95% CI, –7.05 to –2.73; P < 0.00001) and diastolic blood pressure (DBP) ( MD = –3.74; 95% CI, –5.18 to –2.29; P < 0.00001) and can improve endothelium-dependent flow-mediated dilatation ( MD = 2.14; 95% CI, 1.71–2.61; P < 0.00001), and exercise did not reduce pulse wave velocity (PWV) ( MD = 0.03, 95% CI, –0.45–0.50; P = 0.92). Regression analysis showed that changes in exercise-related vascular function were independent of subject medication status, baseline SBP, age and duration of intervention. Conclusion Aerobic, resistance, and high-intensity intermittent exercise all significantly improved SBP, DBP, and FMD in pre- and hypertensive patients, however, they were not effective in reducing PWV, and this effect was independent of the subject’s medication status, baseline SBP, age and duration of intervention. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42022302646.