Publication:

Aerobic exercises and ambulatory blood pressure monitoring in resistant hypertension population: a systematic review

Resistant hypertension associated with increased risk of morbidity and mortality. Here our aim was to systematically evaluate and sum up evidence on the impact of aerobic exercise on ambulatory blood pressure (ABP) in resistant hypertension population. This systematic review followed PRISMA guidelines, and we explored PubMed, Cochrane Library, SCOPUS, and Science Direct for apropos studies. This systematic review included randomized controlled trials and crossover trials focusing on resistant hypertension population undergoing aerobic exercise compared to routine management. The primary outcome was blood pressure (BP) control, which was measured using 24-hour ambulatory blood pressure monitoring (ABPM). Secondary outcome were office blood pressure and adverse effects. Three authors independently selected studies, extracted data, and assessed the risk of bias. The conflicts were resolved by consensus. This systematic review summarizes findings of six randomized controlled trials with 187 participants assessing the impact of exercise on ambulatory blood pressure in resistant hypertension population. Aerobic training was associated with significant reduction of 5-10 mmHg in 24- hour ambulatory BP. Similar pattern was observed in day time BP, while night time BP were less pronounced. Office BP showed inconsistent changes. Exercise interventions, particularly supervised programs and light-to-moderate intensity activities, also improved cardiorespiratory fitness and physical performance. In studies exercise intervention were usually safe and well tolerated without serious adverse events. Moderate evidence supports the addition of aerobic exercise to usual care in resistant hypertension population. However small number of participants and heterogenicity in methodology and outcome limiting the strength of findings.