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Meta-Analysis
. 2025 Feb;48(2):733-743.
doi: 10.1038/s41440-024-01998-9. Epub 2024 Nov 28.

Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials

Hidetaka Morita #  1 , Makiko Abe #  2 , Yasunori Suematsu  3 , Yoshinari Uehara  3   4 , Rie Koyoshi  5 , Kanta Fujimi  6 , Akihito Ideishi  3 , Kohei Takata  7 , Yuta Kato  3 , Tetsuo Hirata  3 , Eiji Yahiro  8 , Natsumi Morito  7 , Ken Kitajima  9 , Atsushi Satoh  10 , Chikara Yoshimura  2 , Shintaro Ishida  2 , Shota Okutsu  11 , Koji Takahashi  12 , Yukiko Shinohara  2 , Takashi Sakaguchi  12 , Shiori Katsuki  12 , Kazuhiro Tada  12 , Takako Fujii  2   13 , Shunsuke Funakoshi  2 , Yaopeng Hu  14 , Tomonori Satoh  15 , Hirofumi Ohnishi  16 , Keisuke Okamura  17 , Hiroyuki Mizuno  18 , Kimika Arakawa  19 , Kei Asayama  20 , Toshio Ohtsubo  21 , Tomoaki Ishigami  22 , Shigeru Shibata  23 , Takayuki Fujita  14 , Masanori Munakata  24 , Mitsuru Ohishi  25 , Atsuhiro Ichihara  26 , Tomohiro Katsuya  27 , Masashi Mukoyama  28 , Hiromi Rakugi  29 , Koichi Node  30 , Hisatomi Arima  31 , Shin-Ichiro Miura  32
Affiliations
Meta-Analysis

Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials

Hidetaka Morita et al. Hypertens Res. 2025 Feb.

Abstract

Hypertension increases the risk of cerebrovascular disease and death. In addition to aerobic exercise, which is currently recommended for its antihypertensive effects, recent studies have suggested that dynamic and isometric resistance exercises also have antihypertensive effects. However, the magnitude of the antihypertensive effect of such resistance exercises is not well known. To clarify the differences in these effects, we conducted an umbrella review of a meta-analysis of randomized controlled trials (RCTs). A systematic search was performed on the Ovid MEDLINE and Cochrane Library, covering the period from inception to August 1, 2023. Eligible studies were RCTs comparing the effects of exercise and non-exercise on office, home, or ambulatory blood pressure (BP) in hypertensive patients aged 18 years or older. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. A sub-analysis determined outcomes by the type of exercise (aerobic exercise, dynamic resistance exercise, isometric resistance exercise, and combined exercise). Eighty-four RCTs with 5065 hypertensive patients were included in the study. All exercise significantly reduced systolic BP (SBP) and diastolic BP (DBP) compared to non-exercise (SBP:-7.52 mmHg, 95% confidence interval [CI] -8.77 to -6.27, p < 0.001; DBP: -4.36 mmHg, 95% CI - 5.15 to -3.57, p < 0.001). There were no significant differences in the magnitude of the reduction in BP between the types of exercise (p for interaction = 0.815 for SBP, p = 0.417 for DBP). These data from 84 RCTs showed that exercise intervention significantly reduced BP and that resistance exercise has a similar antihypertensive effect to aerobic exercise in hypertensive patients. This meta-analysis showed that exercise significantly reduced blood pressure in hypertensive patients. There were no significant differences in the magnitude of this reduction in BP between the types of exercise.

Keywords: Aerobic exercise; Hypertension; Meta-analysis; Resistance exercise.

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Conflict of interest statement

Compliance with ethical standards. Conflict of interest: KO has received grants from Otsuka Holdings. KN has received honoraria from AstraZeneca, Bayer Yakuhin, Boehringer Ingelheim Japan, Daiichi Sankyo, Eli Lilly Japan, Kowa, Mitsubishi Tanabe Pharma, MSD, Novartis Pharma and, Novo Nordisk Pharma, Otsuka, research grants from Astellas, Bayer Yakuhin, Boehringer Ingelheim Japan, Fuji Yakuhin, Mochida Pharmaceutical, and Novartis Pharma, and scholarships from Abbott Medical, Boehringer Ingelheim Japan, Daiichi Sankyo Healthcare, Mitsubishi Tanabe Pharma, and Teijin Pharma. SM has received honoraria from Daiichi Sankyo, Otsuka Pharma. and Novartis Pharma, scholarships from Abbott Medical and Sumitomo Pharma, and research grants from AMGEN, Bayer Yakuhin, Novo Nordisk Pharma, and MSD.

Comment in

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