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EXERCISE IS GOOD FOR YOUR BLOOD PRESSURE: EFFECTS OF ENDURANCE TRAINING AND RESISTANCE TRAINING
Abstract
SUMMARY: Although several epidemiological studies have not observed significant independent relationships between physical activity or fitness and blood pressure, others have concluded that blood pressure is lower in individuals who are more fit or active. However, longitudinal intervention studies are more appropriate for assessing the effects of physical activity on blood pressure. Previously, we have performed meta‐analyses of randomized controlled trials involving dynamic aerobic endurance training or resistance training. Inclusion criteria were: random allocation to intervention and control; physical training as the sole intervention; inclusion of healthy sedentary normotensive and/or hypertensive adults; intervention duration of at least 4 weeks; availability of systolic and/or diastolic blood pressure; and publication in a peer‐reviewed journal up to December 2003. The meta‐analysis on endurance training involved 72 trials and 105 study groups. After weighting for the number of trained participants, training induced significant net reductions of resting and day time ambulatory blood pressure of 3.0/2.4 mmHg (P < 0.001) and 3.3/3.5 mmHg (P < 0.01), respectively. The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (‐6.9/‐4.9) than in the others (‐1.9/‐1.6; P < 0.001 for all). Systemic vascular resistance decreased by 7.1% (P < 0.05), plasma noradrenaline by 29% (P < 0.001) and plasma renin activity by 20% (P < 0.05). Bodyweight decreased by 1.2 kg (P < 0.001), waist circumference by 2.8 cm (P < 0.001), percentage body fat by 1.4% (P < 0.001) and the Homeostatic Model Assessment (HOMA) index of insulin resistance by 0.31 units (P < 0.01). High‐density lipoprotein–cholesterol increased by 0.032 mmol/L (P < 0.05). Resistance training has been less well studied. A meta‐analysis of nine randomized controlled trials (12 study groups) on mostly dynamic resistance training revealed a weighted net reduction of diastolic blood pressure of 3.5 mmHg (P < 0.01) associated with exercise and a non‐significant reduction of systolic blood pressure of 3.2 mmHg (P = 0.10). In conclusion, dynamic aerobic endurance training decreases blood pressure through a reduction of systemic vascular resistance, in which the sympathetic nervous system and the renin–angiotensin system appear to be involved, and favourably affects concomitant cardiovascular risk factors. In addition, the few available data suggest that resistance training is able to reduce blood pressure.
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“In a meta-analysis that included assessment of ambulatory BP 141 it was reported that in studies lasting 4 to 52 weeks, with physical activity as the only intervention, aerobic exercise reduced BP by 3 ⁄ 2.4 mm Hg.”
From Obesity‐Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment: A Position Paper of The Obesity Society and the American Society of Hypertension (2013) · cites this paper as [141]
In the citing paper
“The effect on BP was independent of the estimated weight loss of 1.2 kg.”
From Obesity‐Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment: A Position Paper of The Obesity Society and the American Society of Hypertension (2013) · cites this paper as [141]
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BackgroundMethodSelf-citationType of activity: resistance, aerobic and leisure versus occupational physical activity
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Cited by
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A systematic review of the evidence for Canada's Physical Activity Guidelines for Adults
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“A few studies (141) also examined the effects of resistance training on BP.”
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Cardoso, C. G., Gomides, R. S., Queiroz, A. C. C., Pinto, L. G., Lobo, F. D. S., Tinucci, T., Mion, D., & Forjaz, C. L. M. (2010) · Clinics · doi:10.1590/s1807-59322010000300013 · Cited by 281
“Jessup et al. (40) NT treadmill/(3x/wk 25-45min, 50-85% FCres, 16 wk) ↓(8)/↓(4) →/→ →/→ Ketelhut et al. (41) HT run/(2x/wk, 60 min, 70% FCres, 18 wk) →/↓(11) →/→ →/→ Lima et al. (42) HR aerobic (...) →/→ →/→ →/→ Marceau et al. (43) HT cycle/(3x/wk, 30-45 min, 10 wk) 50% VO 2 max, 70% VO 2 max, →/→ →/→ ↓(6)/↓(5) →/→ →/…”
InfluentialBiomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review
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“Fagard [56] has also suggested a decrease in vascular resistance, driven by the sympathetic nervous system and renin–angiotensin systems, as the main mechanism by which aerobic exercise reduces blood pressure.”
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“In addition, individuals who have aerobic training present with lower blood pressure than nontrained individuals (Fagard, 2006).”
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Pal, S., Radavelli‐Bagatini, S., & Ho, S. S. (2013) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2013.07.004 · Cited by 121
“Interventions varied from 6 to 26 weeks (median, 14 weeks)(28) of two to three weekly sessions with intensity ranging from 30% to 90% (median, 70%) of 1RM.(28,32) Collectively, both aerobic exercise and resistance training seem to improve blood pressure similarly in normotensive or slightly hypertensive adults compare…”
BackgroundKubesch, N. J., de Nazelle, A. J., Guerra, S., Westerdahl, D., Martinez, D. R., Bouso, L., Carrasco‐Turigas, G., Hoffmann, B. H., & Nieuwenhuijsen, M. J. (2014) · European Journal of Preventive Cardiology · doi:10.1177/2047487314555602 · Cited by 113
“Aerobic exercise lowers blood pressure, possibly due to a reduction of peripheral vascular resistance.(51)”
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Pareja-Galeano, H., Garatachea, N., & Lucía, A. (2015) · Progress in molecular biology and translational science · doi:10.1016/bs.pmbts.2015.07.019 · Cited by 117
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“tension are lower in physically active persons [10, 12].”
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“These changes mirror those seen in a meta-analysis by Fagard on the effects of AE on BP [31]; RE yielded decreases in SBP and DBP of 4 and 2 mmHg, respectively.”
ResultResistance Training Is an Effective Tool against Metabolic and Frailty Syndromes
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“2 mmHg associated with resistance training [14].”
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“The PEH observed after a single exercise session on the present study confirmed the results of other studies in normotensive subjects (4,10,11,14,15,24,37,38).”
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Exercise Training and Cardiometabolic Diseases: Focus on the Vascular System
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“It is well established that aerobic exercise training decreases blood pressure [84] through a reduction of vascular resistance [85, 86].”
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Physical Activity and Blood Pressure in Primary School Children
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“In adults, low physical activity (PA) levels are responsible for much of the burden of hypertension, and the BP-lowering effects of regular PA have been reported.(6) However, studies in children have reported inconsistent results.”
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Bjarnason‐Wehrens, B., Schulz, O., Gielen, S., Halle, M., Dürsch, M., Hambrecht, R., Lowis, H., Kindermann, W., Schulze, R., & Rauch, B. (2009) · Clinical Research in Cardiology Supplements · doi:10.1007/s11789-009-0078-8 · Cited by 58
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“Although many studies compared the effect of resistance exercise and aerobic exercise on abdominal fat (24, 27, 28), it is still not clear which of these exercise modalities is better for the reduction of SAT (27, 29).”
BackgroundHypertension and Exercise Training: Evidence from Clinical Studies
Moraes-Silva, I. C., Mostarda, C. T., Silva‐Filho, A. C., & Irigoyen, M. C. (2017) · Advances in experimental medicine and biology · doi:10.1007/978-981-10-4304-8_5 · Cited by 57
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Postexercise Hypotension After Continuous, Aerobic Interval, and Sprint Interval Exercise
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“Most studies indicate that exercise intensity is not an important predictor of the BP reduction after exercise training (8) or after an acute bout of submaximal constant-load exercise (7,9,13,14,19,23,24).”
BackgroundEffects of Physical Exercise on Endothelial Function and DNA Methylation
Ferrari, L., Vicenzi, M., Tarantini, L., Barretta, F., Sironi, S., Baccarelli, A., Guazzi, M., & Bollati, V. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16142530 · Cited by 52
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“This discrepancy may be due, in part, to differences in the participants’ baseline BP values because BP reductions after lifestyle interventions are more pronounced in hypertensive adults than in normotensive adults.(13,34) Our findings may have clinical significance because SBP and DBP reductions of 5 and 2 mmHg are…”
BackgroundThe magnitude and duration of post-exercise hypotension after land and water exercises
Terblanche, E., & Millen, A. (2012) · European Journal of Applied Physiology · doi:10.1007/s00421-012-2398-5 · Cited by 44
Chronic Blood Pressure Reductions and Increments in Plasma Nitric Oxide Bioavailability
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“Various studies have shown that this type of physical exercise decreases BP through a reduction of systemic vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved [11, 24].”
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Concurrent Training Enhances Athletes' Cardiovascular and Cardiorespiratory Measures
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“4 (diastolic) mm Hg (15), with comparable reductions from 12 studies of resistance training (15) and greater reductions in hypertensive subjects (15,27).”
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“Moreover, resis- tance training has been less explored in this population (ACSM, 1998; Fagard, 2006).”
BackgroundInfluence of exercise training mode on arterial diameter: A systematic review and meta-analysis
Black, J. M., Stöhr, E. J., Shave, R., & Esformes, J. I. (2014) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2014.12.007 · Cited by 33
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Rehabilitation in patients with peripheral arterial disease
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“Subjects The determination of sample size was done following the method proposed by Eng (11) using Gpower 3.1.0 (Franz Faul, Universitat Kiel, Germany) software.”
BackgroundMethodInfluentialBarbosa, M. P. D. C. D. R., Júnior, J. N., Cassemiro, B. M., de Souza, N. M., Bernardo, A. F. B., da Silva, A. K. F., Pastre, C. M., & Vanderlei, L. C. M. (2015) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12235 · Cited by 30
“…training on blood pressure, a weighted net change in diastolic blood pressure of 3 5 mmHg (P 0 01) and a non-significant reduction in systolic blood pressure of 3 2 mmHg (P = 0 10) were observed in nine randomized clinical trial reviews involving 12 study groups and 341 participants (Fagard, 2006).”
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Nascimento, L., Santos, A. E. M., Lucena, J., Silva, L., Almeida, A., & Brasileiro-Santos, M. S. (2017) · Trials · doi:10.1186/s13063-017-1985-5 · Cited by 34
“Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training.”
BackgroundResultInfluentialZhou, H., Wang, S., Zhao, C., & He, H. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.1013490 · Cited by 30
Corrick, K. L., Hunter, G. R., Fisher, G., & Glasser, S. P. (2012) · Journal of Clinical Hypertension · doi:10.1111/jch.12050 · Cited by 27
A Mindfulness-Based Physical Activity Intervention: A Randomized Pilot Study
Sala, M., Geary, B. A., & Baldwin, A. S. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000885 · Cited by 26
Butler, K. M., Ramos, J. S., Buchanan, C. A., & Dalleck, L. C. (2018) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s179590 · Cited by 33
“and DBP, respectively, after anywhere between 1 and 6 months of training.(16) Although these changes appear rather unassuming, it has been demonstrated that a blood pressure decrease of as little as 2 mmHg is associated with a 6% decrease in stroke mortality and a 4% decrease in coronary artery disease.”
Chen, Y., Yang, H., Li, D., Zhou, L., Lin, J., Yin, X., Yang, W., Gao, Y., Zhang, Q., Leng, S. X., et al. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108955 · Cited by 26
Endurance training in early life results in long-term programming of heart mass in rats
Wadley, G. D., Laker, R. C., McConell, G. K., & Wlodek, M. E. (2016) · Physiological Reports · doi:10.14814/phy2.12720 · Cited by 25
Is Daily Composition of Movement Behaviors Related to Blood Pressure in Working Adults?
Gupta, N., Dumuid, D., Korshøj, M., Jørgensen, M. B., Søgaard, K., & Holtermann, A. (2018) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001680 · Cited by 24
Influence of exercise type on maternal blood pressure adaptation throughout pregnancy
Murphy, S. E., Johnston, C. A., Strom, C. J., Isler, C. M., Haven, K., Newton, E. R., McDonald, S. M., & May, L. E. (2021) · AJOG Global Reports · doi:10.1016/j.xagr.2021.100023 · Cited by 27
“Research has shown that resistance exercise lowers BP through a decrease in systemic vascular resistance as well.(1,3) However, the mechanism”
BackgroundInfluentialChen, H.-H. (2010) · The Chinese Journal of Physiology · doi:10.4077/cjp.2010.amk042 · Cited by 24
Oliver-Martínez, P. A., Ramos‐Campo, D. J., Martínez-Aranda, L. M., Martínez‐Rodríguez, A., & Rubio‐Arias, J. Á. (2020) · Journal of Hypertension · doi:10.1097/hjh.0000000000002459 · Cited by 22
“For this reason, other training proposals based on strength exercises have demonstrated their effectiveness in lowering blood pressure in a shorter period of time [11].”
BackgroundBraz, N. F. T., Carneiro, M. V., Oliveira‐Ferreira, F., Arrieiro, A. N., Amorim, F. T., Lima, M. M. O., Avelar, N. C. P., Lacerda, A. C. R., & Dias‐Peixoto, M. F. (2012) · Europe PMC (PubMed Central) · Cited by 25
Jae, S. Y., Heffernan, K. S., Yoon, E. S., Park, S. H., Carnethon, M. R., Fernhall, B., Choi, Y., & Park, W. H. (2012) · American Journal of Human Biology · doi:10.1002/ajhb.22313 · Cited by 23
Grover, S. A., Coupal, L., Kouache, M., Lowensteyn, I., Marchand, S., & Campbell, N. R. C. (2011) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2011.01.007 · Cited by 22
Hejazi, K., Iraj, Z. A., Saeidi, A., Hackney, A. C., Laziri, F., Suzuki, K., Laher, I., & Zouhal, H. (2024) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2024.105737 · Cited by 30
Davis, N. L., Tolfrey, K., Jenney, M. E. M., Elson, R., Stewart, C. E., Moss, A. D., Cornish, J., Stevens, M. C. G., & Crowne, E. C. (2020) · Pediatric Blood & Cancer · doi:10.1002/pbc.28687 · Cited by 23
Non-Exercise Estimated Cardiorespiratory Fitness and Incident Hypertension
Patel, P. H., Gates, M., Kokkinos, P. F., Lavie, C. J., Zhang, J., & Sui, X. (2022) · The American Journal of Medicine · doi:10.1016/j.amjmed.2022.01.048 · Cited by 23
Chomiuk, T., Folga, A., & Mamcarz, A. (2013) · Archives of Medical Science · doi:10.5114/aoms.2013.34559 · Cited by 20
“It has been shown in numerous studies [34-38] that BP decreased after the application of endurance exercises, but in some cases, no such relation was observed [39].”
BackgroundDawson, E. A., Sheikhsaraf, B., Boidin, M., Erskine, R. M., & Thijssen, D. H. J. (2021) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13975 · Cited by 20
Patel, D., Böhlke, M., Phattanarudee, S., Kabadi, S. V., Maher, T. J., & Ally, A. (2008) · Neuroscience Research · doi:10.1016/j.neures.2007.12.002 · Cited by 19
“The beneficial effects of exercise intervention, including isometric or static exercise (the subject of this research), include improvements in aerobic capacity, functional ability, lipid profile, physical activity, and neuroprotection (Gordon et al., 2004; Fagard, 2006).”
InfluentialIsometric Handgrip Effects on Hypertension
Millar, P. J., Paashuis, A., & McCartney, N. (2009) · Current Hypertension Reviews · doi:10.2174/157340209787314351 · Cited by 18
“In addition, IHG therapy seems to yield a similar reduction in resting ABP [23] in comparison to conventional aerobic therapy [42, 43].”
ResultNovais, I. D. P., Jarrete, A. P., Puga, G. M., Araújo, H. N., Delbin, M. A., & Zanesco, A. (2017) · Motriz Revista de Educação Física · doi:10.1590/s1980-6574201700010001 · Cited by 18
Schweitzer, A. M., Gingrich, M. A., Hawke, T. J., & Rebalka, I. A. (2020) · European Journal of Applied Physiology · doi:10.1007/s00421-020-04360-2 · Cited by 22
“…reduce functional declines in muscle strength associated with aging, improve insulin resistance and glucose metabolism, reduce body fat, and improve markers of cardiovascular health (American College of Sports Medicine Position Stand 1998; Fagard 2006; Hurley and Hagberg 1998; Kraschnewski et al.”
BackgroundSouza, M. J. D., Williams, N. I., Misra, M. D. D. S. K., Nattiv, A., Joy, E. A., Barrack, M. T., Ricker, E. A., Gorrell, S., Koltun, K. J., O’Donnell, E., et al. (2025) · Sports Medicine · doi:10.1007/s40279-025-02333-z · Cited by 26
Remchak, M. E., Dosik, J. K., Pappas, G., Gow, A. J., Shah, A. M., & Malin, S. K. (2023) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00149.2023 · Cited by 16
Marschin, V., & Herbert, C. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.621272 · Cited by 23
“Among them are faster heart rate recovery from acute stressors, lower blood pressure at rest, weight loss, and lower risk of cardiovascular and non-communicable chronic diseases (Cornelissen and Fagard, 2005; Penedo and Dahn, 2005; Fagard, 2006; Forcier et al., 2006; Blair and Morris, 2009).”
BackgroundInteraction between leptin and leisure-time physical activity and development of hypertension
Asferg, C. L., Møgelvang, R., Flyvbjerg, A., Frystyk, J., Jensen, J. S., Marott, J. L., Appleyard, M., Schnohr, P., Jensen, G. B., & Jeppesen, J. (2011) · Blood Pressure · doi:10.3109/00365599.2011.586248 · Cited by 17
Grafe, K., Bendick, P., Burr, M., Boura, J., & Franklin, B. A. (2018) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2018.1519385 · Cited by 16
“Evidence for the blood pressure-lowering effect of RT has been less compelling compared with regular aerobic exercise (Fagard, 2006).”
BackgroundResposta pressórica após exercício resistido de diferentes segmentos corporais em hipertensos
Battagin, A. M., Corso, S. D., Soares, C. L. R., Ferreira, S. R., Letícia, A., de Souza, C., & Malaguti, C. (2010) · Arquivos Brasileiros de Cardiologia · doi:10.1590/s0066-782x2010005000117 · Cited by 18
Barbosa, M. P. D. C. D. R., Oliveira, V. C., da Silva, A. K. F., Pérez‐Riera, A. R., & Vanderlei, L. C. M. (2017) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12445 · Cited by 15
“…on cardiorespiratory parameters (Vincent et al., 2002; Cornelissen & Fagard, 2005; Cooke & Carter, 2005; Sarsan et al., 2006; Mark et al., 2007; Brentano et al., 2008; Collier et al., 2009; Fagard, 2006; Ho et al., 2012; Kim & Kim, 2013; Pal et al., 2013; Caruso et al., 2015; Shultz et al., 2015).”
BackgroundLow-frequency electromyostimulation and chronic heart failure
Casillas, J.-M., Grémeaux, V., Labrunée, M., Troigros, O., Laurent, Y., Deley, G., & Eicher, J. (2008) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2008.04.006 · Cited by 14
“Un effet de l’entraı̂nement sur le système rénine–angiotensine–aldostérone n’a été montré à ce jour au cours de l’ICC que chez l’animal [56], à la différence de l’hypertension artérielle [24].”
BackgroundTedesco, A. F., & Ally, A. (2009) · Neuroscience Research · doi:10.1016/j.neures.2009.04.008 · Cited by 15
Entraînement à l'effort au cours des pathologies cardiovasculaires
Casillas, J.-M., Grémeaux, V., Damak, S., Feki, A., & Pérennou, D. A. (2007) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2007.03.008 · Cited by 15
Seron, B. B., Goessler, K., Modesto, E. L., de Almeida, E. W., & Greguol, M. (2015) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20150033 · Cited by 10
Metadata
- Authors
- Fagard, R.
- Venue
- Clinical and Experimental Pharmacology and Physiology
- Publisher
- Wiley
- Published
- 2006-08-10
- Volume
- 33
- Issue
- 9
- Pages
- 853-856
- ISSN
- 0305-1870 (ISSN-L)
- 1440-1681
- OpenAlex
- W2059173308
- Cited by
- 265
- References
- 20
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 10 · 2023: 7 · 2022: 8 · 2021: 15 · 2020: 20 · 2019: 16 · 2018: 15 · 2017: 21 · 2016: 7 · 2015: 13 · 2014: 18 · 2013: 12 · 2012: 21
- FWCI
- 27.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical and Experimental Pharmacology and Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- blood pressure, endurance training, resistance training, aerobic exercise, hypertension, ambulatory blood pressure, systemic vascular resistance, plasma norepinephrine, plasma renin activity, body composition, insulin resistance, HDL cholesterol, physical activity, sedentary adults, cardiovascular risk reduction, weight loss, waist circumference, body fat percentage, HOMA
- MeSH terms
- Blood Glucose, Blood Pressure, Body Composition, Body Weight, Cardiovascular Diseases, Cholesterol, Clinical Trials as Topic, Heart Rate, Humans, Insulin, Cholesterol, HDL, Cholesterol, LDL, Oxygen Consumption, Physical Endurance, Risk Factors, Teaching, Triglycerides, Vascular Resistance, Exercise
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