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Differences in the effects of exercise on blood pressure depending on the physical condition of the subject and the type of exercise: a systematic review and meta-analysis

Hypertension Research volume 48, pages 720–732 (2025)Cite this article

A Comment to this article was published on 20 December 2024

Abstract

Although hypertension is a major cause of cardiovascular disease, the control of blood pressure (BP) is insufficient worldwide. Exercise is an effective treatment for reducing BP, but the differences in the blood pressure lowering effects of exercise according to the underlying pathophysiological condition, the type of exercise, and the geographic region are not fully understood. An umbrella review with a meta-analysis of 435 randomized controlled trials that investigated the BP-lowering effects of exercise was performed using Ovid MEDLINE and the Cochrane Library, covering the period from inception to August 1, 2023. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. Exercise significantly reduced systolic BP in healthy subjects (−3.51 mmHg, 95% confidence interval: −3.90, −3.11; p < 0.001) and in those with lifestyle-related diseases including hypertension (−5.48 mmHg, −6.51, −4.45; p < 0.001), but not in those with cardiovascular diseases (−1.16 mmHg, −4.08, 1.76; p = 0.44). According to the type of exercise, all types significantly reduced systolic BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases. According to the region, in Oceania, there were no reductions in systolic BP. In Asia, systolic BP was reduced in patients with cardiovascular diseases. In conclusion, any type of exercise reduced BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases, and the region affected the effect of exercise. When using exercise to reduce hypertension, it is important to consider the patient’s pathophysiological condition and the region.

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Author information

Authors and Affiliations

  1. Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan

    Yasunori Suematsu, Yuta Kato & Tetsuo Hirata

  2. Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan

    Hidetaka Morita

  3. Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Makiko Abe, Chikara Yoshimura, Shintaro Ishida, Yukiko Shinohara, Takako Fujii, Shunsuke Funakoshi & Hisatomi Arima

  4. Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan

    Yoshinari Uehara

  5. Division of Medical Safety Management, Fukuoka University Hospital, Fukuoka, Japan

    Rie Koyoshi

  6. Department of Rehabilitation, Fukuoka University Hospital, Fukuoka, Japan

    Kanta Fujimi

  7. Department of Cardiology, Fukuoka University Faculty of Medicine, Fukuoka, Japan

    Akihito Ideishi & Shin-ichiro Miura

  8. Department of Clinical Laboratory Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan

    Kohei Takata & Natsumi Morito

  9. Postgraduate Clinical Training Center, Fukuoka University Hospital, Fukuoka, Japan

    Eiji Yahiro

  10. Medical Education Center, Fukuoka University Faculty of Medicine, Fukuoka, Japan

    Ken Kitajima

  11. Miyase Clinic, Fukuoka, Japan

    Yuiko Yano

  12. Laboratory of Epidemiology and Prevention, Kobe Pharmaceutical University, Kobe, Japan

    Atsushi Satoh

  13. Department of General Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan

    Shota Okutsu

  14. Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Koji Takahashi, Takashi Sakaguchi, Shiori Katsuki & Kazuhiro Tada

  15. NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan

    Takako Fujii

  16. Department of Physiology, Fukuoka University School of Medicine, Fukuoka, Japan

    Yaopeng Hu & Takayuki Fujita

  17. Research Center for the Promotion of Health and Employment Support, Tohoku Rosai Hospital, Sendai, Japan

    Tomonori Satoh & Masanori Munakata

  18. Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan

    Hirofumi Ohnishi

  19. Department of Cardiology and Cardiovascular Center, Imamura Hospital, Tosu, Japan

    Keisuke Okamura

  20. Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

    Hiroyuki Mizuno

  21. National Hospital Organization, Kyushu Medical Center, Department of Clinical Laboratory, Fukuoka, Japan

    Kimika Arakawa

  22. Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan

    Kei Asayama

  23. Department of Hypertension Internal Medicine, Fukuoka Red Cross Hospital, Fukuoka, Japan

    Toshio Ohtsubo

  24. Department of Cardiology, Yokohama City University Hospital, Yokohama, Japan

    Tomoaki Ishigami

  25. Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan

    Shigeru Shibata

  26. Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan

    Mitsuru Ohishi

  27. Department of Medicine, Tokyo Women’s Medical University, Tokyo, Japan

    Atsuhiro Ichihara

  28. Katsuya Clinic, Amagasaki, Japan

    Tomohiro Katsuya

  29. Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan

    Masashi Mukoyama

  30. Osaka Rosai Hospital, Sakai, Japan

    Hiromi Rakugi

  31. Department of Cardiovascular Medicine, Saga University, Saga, Japan

    Koichi Node

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Correspondence to Shin-ichiro Miura.

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Conflict of interest

KO has received grants from Otsuka Holdings. KN has received honoraria from AstraZeneca, Bayer Yakuhin, Boehringer Ingelheim Japan, Daiichi Sankyo, Eli Lilly Japan, Kowa, Mitsubishi Tanabe Pharma, MSD, Novartis Pharma, Novo Nordisk Pharma, Otsuka; research grants from Astellas, Bayer Yakuhin, Boehringer Ingelheim Japan, Fuji Yakuhin, Mochida Pharmaceutical, Novartis Pharma; and scholarships from Abbott Medical, Boehringer Ingelheim Japan, Daiichi Sankyo Healthcare, Mitsubishi Tanabe Pharma, Teijin Pharma. SM has received honoraria from Daiichi Sankyo, Otsuka Pharma. and Novartis Pharma, scholarships from Abbott Medical and Sumitomo Pharma, and research grants from AMGEN, Bayer Yakuhin, Novo Nordisk Pharma, and MSD.

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Suematsu, Y., Morita, H., Abe, M. et al. Differences in the effects of exercise on blood pressure depending on the physical condition of the subject and the type of exercise: a systematic review and meta-analysis. Hypertens Res 48, 720–732 (2025). https://doi.org/10.1038/s41440-024-01974-3

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