Association between Physical Activity Advice Only or Structured Exercise Training with Blood Pressure Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
Abstract
Background Diabetes is associated with marked cardiovascular morbidity and mortality. However, the association between different types of exercise training and blood pressure (BP) changes is not fully clear in type 2 diabetes.Objective The aim of this systematic review and meta-analysis of randomized controlled clinical trials (RCTs) was to determine the effects of structured exercise training (aerobic [AER], resistance [RES], or combined [COMB]) and physical activity (PA) advice only on BP changes in patients with type 2 diabetes.Methods Searches in five electronic databases were conducted to retrieve studies published from 1980 to 2013. Eligible studies were RCTs consisting of structured exercise training or PA advice versus no intervention in patients with type 2 diabetes. We used random effect models to derive weighted mean differences (WMDs) of exercises on absolute changes in systolic BP (SBP) and diastolic BP (DBP).Results A total of 30 RCTs of structured training (2,217 patients) and 21 of PA advice (7,323 patients) were included. Data were extracted independently in duplicate. Structured exercise was associated with reductions in SBP (WMD -4.22 mmHg; 95% confidence interval [CI] -5.89 to -2.56) and DBP (WMD -2.07 mmHg; 95% CI -3.03 to -1.11) versus controls. In structured exercise interventions, AER and RES were associated with declines in BP, and COMB was not associated with BP changes. However, in sensitivity analysis, a high-intensity protocol within COMB was associated with declines in SBP (WMD -3.30 mmHg; 95% CI -4.71 to -1.89). Structured exercise longer than 150 min/week was associated with greater BP reductions. PA advice only was associated with reduction in SBP (WMD -2.97 mmHg; 95% CI -4.52 to -1.43) and DBP (WMD -1.41 mmHg; 95% CI -1.94 to -0.88) versus controls.Conclusions AER, RES, and high-intensity combined training are associated with BP reduction in patients with type 2 diabetes, especially in exercise programs lasting more than 150 min/week. PA advice only is also associated with lower BP levels.
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A similar meta-analysis of unsupervised behavioural interventions in people with type 2 diabetes on systolic blood pressure suggested a small but significant effect, with a weighted mean difference of 3 mm Hg (95% CI −5 to −1).
“A similar meta-analysis of unsupervised behavioural interventions in people with T2D on systolic blood pressure suggested a small (weighted mean difference of 3 mm Hg, 95% CI −5 to −1) but significant effect.56”
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References 101 · Cited by 57
- Authors
- Figueira, F. R., Umpierre, D., Cureau, F. V., Zucatti, A. T. N., Dalzochio, M. B., Leitão, C. B., & Schaan, B. D.
- Affiliations
- Hospital de Clínicas de Porto Alegre (BR)
- Universidade Federal do Rio Grande do Sul (BR)
- Corresponding author
- Schaan, Beatriz D.
- Venue
- Sports Medicine
- Published
- 2014-07-22
- Volume
- 44
- Issue
- 11
- Pages
- 1557-1572
- ISSN
- 0112-1642 (ISSN-L)
- 1179-2035
- OpenAlex
- W2089379032
- Cited by
- 57
- References
- 101
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 8 · 2019: 4 · 2018: 5 · 2017: 10 · 2016: 6 · 2015: 3
- FWCI
- 0.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- type 2 diabetes, blood pressure, physical activity guidelines, aerobic exercise, resistance training, concurrent training, high-intensity training, systolic blood pressure, diastolic blood pressure, cardiovascular risk, exercise duration, cardiovascular morbidity and mortality, lifestyle intervention, glycemic control, weight loss, insulin sensitivity, lipid profile, endothelial function
- MeSH terms
- Blood Pressure, Diabetes Mellitus, Type 2, Humans, Exercise, Randomized Controlled Trials as Topic, Directive Counseling, Resistance Training
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