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Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors
Abstract
Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure–regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of ≥4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm Hg ( P <0.001) and 3.3/3.5 mm Hg ( P <0.01). 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 norepinephrine by 29% ( P <0.001), and plasma renin activity by 20% ( P <0.05). Body weight decreased by 1.2 kg ( P <0.001), waist circumference by 2.8 cm ( P <0.001), percent body fat by 1.4% ( P <0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U ( P <0.01); HDL cholesterol increased by 0.032 mmol/L −1 ( P <0.05). In conclusion, aerobic endurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors.
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“Regular exercise improves blood pressure control and lipid profiles, reduces the incidence of diabetes and myocardial infarction, and increases life expectancy.6–9”
From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [6]
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“Increased cardiorespiratory fitness is associated with a progressive reduction of cardiovascular events, which would seem to be at odds with the aforementioned link between lifelong exercise load and increased coronary atherosclerosis.”
From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [6]
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2007 Guidelines for the Management of Arterial Hypertension
Mancia, G., Backer, G. D., Dominiczak, A. F., Cífková, R., Fagard, R. H., Germanò, G., Grassi, G. M., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., et al. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3281fc975a · Cited by 5,870
“9mmHg in hypertensive participants [369].”
BackgroundSelf-citation2013 ESH/ESC Guidelines for the management of arterial hypertension
Mancia, G., Fagard, R. H., Narkiewicz, K., Redón, J., Zanchetti, A., Böhm, M., Christiaens, T. C., Cífková, R., Backer, G. D., Dominiczak, A. F., et al. (2013) · Blood Pressure · doi:10.3109/08037051.2013.812549 · Cited by 430
“This will improve not only BP but also the metabolic components of the pattern and delay the onset of diabetes [369,519,520].”
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Self-citation2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
Self-citationExercise Training for Blood Pressure: A Systematic Review and Meta‐analysis
Cornelissen, V. A., & Smart, N. A. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.112.004473 · Cited by 1,683
Self-citation
Metadata
- Authors
- Cornelissen, V. A., & Fagard, R. H.
- Affiliations
- From the Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, Catholic University of Leuven, Belgium.
- UCLouvain (BE)
- Venue
- Hypertension
- Published
- 2005-10
- Volume
- 46
- Issue
- 4
- Pages
- 667-675
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2163161539
- Cited by
- 1,005
- References
- 0
- Citations by year
- 2026: 28 · 2025: 47 · 2024: 33 · 2023: 38 · 2022: 52 · 2021: 41 · 2020: 49 · 2019: 46 · 2018: 47 · 2017: 52 · 2016: 49 · 2015: 63 · 2014: 76 · 2013: 79 · 2012: 58
- FWCI
- 64.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek
- Vlaamse regering
- 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
- aerobic endurance training, blood pressure, ambulatory blood pressure, systemic vascular resistance, plasma norepinephrine, plasma renin activity, renin-angiotensin system, sympathetic nervous system, cardiovascular risk factors, insulin resistance, HDL cholesterol, body weight, waist circumference, fat mass
- MeSH terms
- Blood Pressure, Cardiovascular Diseases, Hemodynamics, Humans, Norepinephrine, Physical Education and Training, Physical Endurance, Regression Analysis, Renin, Rest, Risk Factors, Vascular Resistance, Randomized Controlled Trials as Topic, Cross-Over Studies, Blood Pressure Monitoring, Ambulatory
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