Key result
Exercise reduced systolic blood pressure by 4.40 mm Hg (95% CI -5.78 to -3.01) at 3 to 6 months in younger adults, but this benefit was lost after 12 months of follow-up.
Why the study?
Does a defined physical activity strategy reduce blood pressure in younger adults with prehypertension and hypertension?
Meta-Analysis (n=3,614)
Does a defined physical activity strategy reduce blood pressure in younger adults with prehypertension and hypertension?
Mean Difference: -4.4 (95% CI -5.78–-3.01)
Exercise advice provides short-term blood pressure reduction in young adults, but the effect is not sustained at 12 months, suggesting current guidance may be insufficient for long-term cardiovascular risk reduction.
Exercise yields only transient BP reductions in younger adults; leaves open durability of guidance and need for age-specific trials.
Previous studies report benefits of exercise for blood pressure control in middle age and older adults, but longer-term effectiveness in younger adults is not well established. We performed a systematic review and meta-analysis of published randomized control trials with meta-regression of potential effect modifiers. An information specialist completed a comprehensive search of available data sources, including studies published up to June 2015. Authors applied strict inclusion and exclusion criteria to screen 9524 titles. Eligible studies recruited younger adults with a cardiovascular risk factor (with at least 25% of cohort aged 18-40 years); the intervention had a defined physical activity strategy and reported blood pressure as primary or secondary outcome. Meta-analysis included 14 studies randomizing 3614 participants, mean age 42.2±6.3 (SD) years. At 3 to 6 months, exercise was associated with a reduction in systolic blood pressure of -4.40 mm Hg (95% confidence interval, -5.78 to -3.01) and in diastolic blood pressure of -4.17 mm Hg (95% confidence interval, -5.42 to -2.93). Intervention effect was not significantly influenced by baseline blood pressure, body weight, or subsequent weight loss. Observed intervention effect was lost after 12 months of follow-up with no reported benefit over control, mean difference in systolic blood pressure -1.02 mm Hg (95% confidence interval, -2.34 to 0.29), and in diastolic blood pressure -0.91 mm Hg (95% confidence interval, -1.85 to 0.02). Current exercise guidance provided to reduce blood pressure in younger adults is unlikely to benefit long-term cardiovascular risk. There is need for continued research to improve age-specific strategies and recommendations for hypertension prevention and management in young adults.
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Williamson et al. (2016) conducted a meta-analysis in Prehypertension and Hypertension (n=3,614). Exercise vs. Control was evaluated on Systolic blood pressure at 3 to 6 months (MD -4.40, 95% CI -5.78 to -3.01). Exercise reduced systolic blood pressure by 4.40 mm Hg (95% CI -5.78 to -3.01) at 3 to 6 months in younger adults, but this benefit was lost after 12 months of follow-up.
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