Acute And Chronic Effects Of Resistance Exercise On Ambulatory Blood Pressure: Systematic Review And Meta-analysis

PURPOSE: Systematic review and meta-analysis was to verify the acute and chronic effects of isolated resistance exercise on ambulatory blood pressure (BP) in healthy and unhealthy subjects. METHODS: PubMed and Web of Science databases were searched for studies published until September 2022, meeting the following eligibility criteria: a) randomized crossover trials, randomized controlled trials and non-randomized non-controlled trials of isolated resistance exercise in adults and/or elderly; b) monitoring of at least one ambulatory BP parameter (i.e., 24 h, awake and asleep ambulatory BP, nocturnal fall and morning surge in BP). Mean differences (MDs) with a 95% confidence interval (95% CI) were calculated using an inverse variance method with a random effects model. Twenty-seven studies were included, with 17 investigating the acute (411 participants), nine the chronic (356 participants) and one both the acute and chronic (13 participants) effects of resistance exercise on ambulatory BP. RESULTS: The meta-analysis for the acute studies showed lower asleep systolic BP in cardiovascular disease patients (MD: -1.31; 95% CI: -2.27, -0.34; p = 0.008), and lower awake diastolic BP in healthy subjects (MD: -0.77; 95% CI: 1.51, -0.03; p = 0.04) compared to the control condition. Meta-analysis for the chronic studies showed a significant reduction in 24-hour diastolic BP in cardiovascular disease patients (MD: -0.77-1.37; 95% CI: -2.74, -0.01; p = 0.05), and overall (MD: -1.32; 95% CI: -2.29, -0.35; p = 0.008). Also, the meta-analysis revealed a reduction in awake systolic and diastolic BP in cardiovascular disease patients (Systolic - MD: -4.54; 95% CI: -8.02, -1.05; p = 0.01; Diastolic - MD: -1.74; 95% CI: -3.10, -0.38; p = 0.01) and overall (Systolic - MD: -4.32; 95% CI: -7.09, -1.55; p = 0.002; Diastolic - MD: -1.33; 95% CI: -2.31, -0.35; p = 0.008). CONCLUSION: Resistance exercise acutely leads to lower asleep systolic and awake diastolic BP in cardiovascular disease patients and healthy subjects, respectively, while chronically it leads to a reduction in 24-hour diastolic BP and awake systolic and diastolic BP mainly in cardiovascular disease patients. Keywords: Strength training; blood pressure; exercise.