IMPACT OF EXERCISE ON SHORT-TERM BLOOD PRESSURE VARIABILITY: A NETWORK META-ANALYSIS OF CLINICAL TRIALS

Objective: Increasingly recognized as an independent risk factor for cardiovascular diseases, blood pressure variability (BPV) has prompted numerous studies into the potential of regular physical exercise to reduce it. This research aimed to determine whether exercise can effectively serve as an intervention for controlling short-term BPV. Design and method: A literature search was conducted on MEDLINE, Embase, and PsycINFO on Feb 19, 2024. The search included clinical trials and observational studies examining the effects of exercise on systolic and diastolic blood pressure variability (BPV). Mean differences and standard deviations of BPV measurements were extracted to calculate standardized mean differences (SMD) along with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2statistic, and random effects models were utilized for the analysis. Results: Our search identified 8359 studies, of which 23 studies reported BPV outcomes. Among these, 13 clinical trials compared short-term BPV between participants who exercised and those who did not. The results indicated that exercise interventions significantly reduced both systolic BPV (SMD (95% CI) = -0.38 (-0.63 to -0.12)) and diastolic BPV (SMD = -0.52 (-0.79 to -0.24)), with more pronounced benefits observed in individuals with hypertension. In network meta-analyses comparing different types of exercise, aerobic exercise demonstrated greater efficacy in improving BPV, particularly diastolic BPV, compared to no exercise (SMD = -1.53 (-2.52 to -0.64)). (Figure 1)Conclusions: Exercise significantly reduces both systolic and diastolic blood pressure variabilities, with greater benefits observed in individuals with hypertension. Network meta-analyses indicated that aerobic exercise is particularly effective, especially for reducing diastolic BPV.