Dynamic Resistance Training as Stand-Alone Antihypertensive Lifestyle Therapy: A Meta-Analysis

Background: Aerobic exercise (AE) is recommended as first-line antihypertensive lifestyle therapy based on strong evidence showing that it lowers blood pressure (BP) 5 to 7 mm Hg among adults with hypertension. Because of weaker evidence showing that dynamic resistance training (RT) reduces BP 2 to 3 mm Hg among adults with hypertension, it is recommended as adjuvant lifestyle therapy to AE training. Yet, existing evidence suggests that dynamic RT can lower BP as much or more than AE.

Methods and results: We meta-analyzed 64 controlled studies (71 interventions) to determine the efficacy of dynamic RT as stand-alone antihypertensive therapy. Participants (N=2344) were white (57%), middle-aged (47.2±19.0 years), and overweight (26.8±3.4 kg/m(2)) adults with prehypertension (126.7±10.3/76.8±8.7 mm Hg); 15% were on antihypertensive medication. Overall, moderate-intensity dynamic RT was performed 2.8±0.6 days/week for 14.4±7.9 weeks and elicited small-to-moderate reductions in systolic BP (SBP; d+=-0.31; 95% CIs, -0.43, -0.19; -3.0 mm Hg) and diastolic BP (DBP; d+=-0.30; 95% CIs, -0.38, -0.18; -2.1 mm Hg) compared to controls (Ps<0.001). Greater BP reductions occurred among samples with higher resting SBP/DBP: ≈6/5 mm Hg for hypertension, ≈3/3 mm Hg for prehypertension, and ≈0/1 mm Hg for normal BP (Ps<0.023). Furthermore, nonwhite samples with hypertension experienced BP reductions that were approximately twice the magnitude of those previously reported following AE training (-14.3 mm Hg [95% CIs, -19.0, -9.4]/-10.3 mm Hg [95% CIs, -14.5, -6.2]).

Conclusions: Our results indicate that for nonwhite adult samples with hypertension, dynamic RT may elicit BP reductions that are comparable to or greater than those reportedly achieved with AE training. Dynamic RT should be further investigated as a viable stand-alone therapeutic exercise option for adult populations with high BP.