Effects of exercise on pulse wave velocity in hypertensive and prehypertensive patients: a systematic review and meta-analysis of randomized controlled trials

Background This study aimed to examine the effects of exercise on pulse wave velocity (PWV) in hypertensive and prehypertensive patients. Methods A comprehensive search was performed in PubMed, Cochrane, Embase, Scopus, and Web of Science, covering data up to August 31, 2023. A meta-analysis was conducted to determine the weighted mean difference (WMD) and 95% confidence interval for the effects of exercise on PWV in hypertensive and prehypertensive patients. Results A total of 17 studies met the inclusion criteria. Exercise had a significant effect on improving PWV in hypertensive and prehypertensive patients (WMD, −0.93, P = 0.0001). Subgroup analysis showed that aerobic exercise (WMD, −1.29, P = 0.0004) significantly improved PWV in hypertensive and prehypertensive patients. Moreover, aerobic exercise, specifically moderate-intensity aerobic exercise (WMD, −1.69, P = 0.03), conducted for ≥12 weeks (WMD, −1.54, P = 0.002), ≥3 times per week (WMD, −1.44, P = 0.002), ≤60 min per session (WMD, −1.50, P = 0.02), and ≥180 min per week (WMD, −0.57, P = 0.005), was more effective in improving PWV in hypertensive and prehypertensive patients, especially in middle-aged individuals (WMD, −1.78, P < 0.0001). Conclusion To improve arterial stiffness, hypertensive and prehypertensive patients, particularly middle-aged individuals, are recommended to participate in a minimum of 12 weeks of moderate-intensity aerobic exercise at least 3 times per week for less than 60 min per session, with a goal of 180 min per week being achieved by increasing the frequency of exercise. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=458981 , identifier: CRD42023458981.