Exercise characteristics and the blood pressure response to dynamic physical training

Purpose: The purpose of this study was to assess the influence of the characteristics of the exercise program, particularly exercise intensity, on the blood pressure response to dynamic physical training in otherwise healthy normotensive and hypertensive subjects. Methods: This study is a meta-analysis of randomized controlled intervention trials and a description of studies in which different training regimens have been compared. Results: The weighted net reduction of blood pressure in response to dynamic physical training averaged 3.4/2.4 mm Hg (P < 0.001). Interstudy differences in the changes in pressure were not related to weekly frequency, time per session, or exercise intensity, which ranged from approximately 45-85%; these three characteristics combined explained less than 5% of the variance of the blood pressure response. The response of diastolic blood pressure was not different according to training intensity in studies that randomized patients to training programs with different intensities. Some studies reported a greater reduction of systolic blood pressure when intensity was about 40% than when participants exercised at about 70%, but this finding was not consistent, neither within nor between studies. Conclusion: Training from three to five times per week during 30-60 min per session at an intensity of about 40-50% of net maximal exercise performance appears to be effective with regard to blood pressure reduction. The evidence that higher intensity exercise would be less effective is at present inconsistent.