Key result
Aquatic exercise lowers systolic blood pressure by ~11 mmHg vs control in hypertension.
Why the study?
Aquatic exercise is an important non-pharmacological intervention for hypertension, but its effectiveness in managing blood pressure remains controversial.
Does aquatic exercise reduce resting blood pressure in individuals with primary hypertension?
Meta-Analysis (n=421)
Does aquatic exercise reduce resting blood pressure in individuals with primary hypertension?
Mean Difference: -10.68 (95% CI -13.81–-7.54)
p-value: p=<0.0001
Aquatic exercise significantly reduces resting systolic and diastolic blood pressure in hypertensive patients, supporting its use as an effective non-pharmacological lifestyle intervention.
Supports aquatic exercise for BP reduction in hypertension; extends exercise evidence to water-based modalities in RCTs.
Background Hypertension remains one of the most prevalent health risks globally. Aquatic exercise is considered an important non-pharmacological intervention for hypertension; however, its effectiveness in managing blood pressure in hypertensive patients remains controversial. The aim of this study was to systematically evaluate and conduct a meta-analysis to assess the effects of aquatic exercise on blood pressure and related parameters in individuals with hypertension. Methods This study followed the PRISMA and Cochrane methodological guidelines. A systematic search was conducted across PubMed, Embase, Web of Science, and Cochrane Library databases. Statistical analyses and funnel plots were generated using R software for the included studies. A total of nine randomized controlled trials (RCTs), contributing up to 12 intervention-control comparisons, were included in the final analysis. Random-effects models were applied to pool effect sizes, and publication bias was assessed. Results Nine RCTs involving 421 participants were included, contributing up to 12 intervention-control comparisons to the quantitative synthesis. Aquatic exercise significantly reduced systolic blood pressure (MD = -10.68 mmHg, 95% CI: -13.81, -7.54, P < 0.0001; I ² = 17.0%) and diastolic blood pressure (MD = -5.85 mmHg, 95% CI: -8.00, -3.69, P < 0.0001; I ² = 0%). However, no statistically significant improvements were found in heart rate (MD = -1.99 bpm, 95% CI: -6.47, 2.48, P = 0.3824; I ² = 38.8%) or pulse wave velocity (MD = -0.68 m/s, 95% CI: -2.22 to 0.87, P = 0.3913; I² = 65.5%) ( P > 0.05). Thus, aquatic exercise did not significantly improve arterial stiffness in hypertensive patients. Conclusion Aquatic exercise significantly reduces systolic and diastolic blood pressure in hypertensive individuals. However, its effects on heart rate and pulse wave velocity are not statistically significant, indicating that it does not have a substantial impact on arterial stiffness in hypertensive patients. Further high-quality research is needed to confirm these findings.
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Chang et al. (2026) conducted a meta-analysis in Hypertension (n=421). Aquatic exercise vs. No exercise intervention or only low-intensity activities was evaluated on Systolic blood pressure (MD -10.68, 95% CI -13.81, -7.54, p=<0.0001). Aquatic exercise significantly reduced systolic blood pressure by 10.68 mmHg and diastolic blood pressure by 5.85 mmHg compared to control conditions in patients with hypertension.
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