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1- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.
2- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India. & Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
3- Physical Education and Sports, Division of Humanities and Political Sciences, Hellenic Naval Academy, Piraeus, Greece.
4- Faculty of Sport Science, Universitas Negeri Padang, Padang, Indonesia.
5- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia. , suhanakk@usm.my
6- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
7- Department of Human Physiology, Federal University Dutse, Jigawa, Nigeria.
8- Staff Physician, Adult Stem Cell Transplant and Cellular Therapy, Department of Oncology, King Abdul-Aziz Medical City, Riyadh, Kingdom of Saudi Arabia.
9- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Karies 42100, Trikala, Greece. & School of Physical Education and Sport Science, Department of Physical Education and Sport Science, Komotini 69100, Greece.
Abstract:   (1130 Views)
Background. Hypertension, a major contributor to heart disease, is linked to severe complications such as heart attacks, strokes, myocardial infarctions, and chronic kidney disease. Various types of exercise present a promising strategy for lowering BP in both hypertensive and normotensive individuals, thereby reducing the risk of cardiovascular diseases.
Objectives. This study aimed to assess the impact of aerobic, resistance, and combined training on BP regulation in patients with chronic diseases.
Methods. A comprehensive search was conducted using relevant keywords across SCOPUS, PubMed, the Cochrane Central Database, and Google Scholar. Eighteen articles meeting pre-defined inclusion and exclusion criteria were selected for review. The search covered papers published from January 1, 1995, through May 31, 2024.
Results. The analysis revealed that aerobic exercise performed three times per week for 10 weeks led to significant reductions in systolic (SBP) and diastolic (DBP) blood pressure in obese patients with cardiovascular disease. Aerobic exercise showed a meaningful alteration in BP by reducing systemic vascular resistance in patients with metabolic syndrome. Moreover, aerobic and resistance training were more effective in lowering mean arterial pressure in individuals with pre- and stage-1 hypertension and type 2 diabetes. Combined aerobic and resistance training, performed three times per week for 12 weeks, led to a significant reduction in both SBP and DBP.
Conclusion. These findings highlight the crucial role of exercise therapy as a non-pharmacological approach to managing BP and reducing cardiovascular risk factors
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APPLICABLE REMARKS
  • The study demonstrates that both aerobic and resistance training, when performed consistently, can effectively lower systolic and diastolic blood pressure in patients with chronic conditions, emphasizing the potential of exercise therapy in managing cardiovascular risk factors.
  • Aerobic exercise, in particular, significantly reduces systemic vascular resistance, making it a viable non-pharmacological intervention for patients with metabolic syndrome and those at risk of developing cardiovascular diseases.
  • Combining aerobic and circuit-based resistance training over 12 weeks was particularly beneficial in reducing mean arterial pressure, especially in individuals with pre- and stage-1 hypertension and type 2 diabetes.
  • These findings reinforce the importance of integrating structured exercise programs into the treatment plans for hypertensive patients, offering a complementary approach to traditional pharmacological treatments to manage blood pressure better and mitigate cardiovascular risks.

Type of Study: Review Article | Subject: Sport Physiology and its related branches
Received: 2024/09/1 | Accepted: 2024/11/4

References
1. Garovic VD, Hayman SR. Hypertension in pregnancy: an emerging risk factor for cardiovascular disease. Nature clinical practice Nephrology. 2007;3(11):613-22. [DOI:10.1038/ncpneph0623] [PMID]
2. Mutalub YB, Abdulwahab M, Mohammed A, Yahkub AM, Al-Mhanna SB, Yusof W, et al. Gut microbiota modulation as a novel therapeutic strategy in cardiometabolic diseases. Foods. 2022;11(17):2575. [DOI:10.3390/foods11172575] [PMID] []
3. Tonelli M, Wiebe N, Guthrie B, James MT, Quan H, Fortin M, et al. Comorbidity as a driver of adverse outcomes in people with chronic kidney disease. Kidney international. 2015;88(4):859-66. [DOI:10.1038/ki.2015.228] [PMID]
4. Al-Mhanna SB, Wan Ghazali WS, Maqsood A, Mohamed M, Ahmed N, Afolabi HA, et al. Physical activities pre-and post-COVID-19 vaccination and its implementations: A narrative review. SAGE Open Med. 2023;11:20503121231158981. [DOI:10.1177/20503121231158981] [PMID] []
5. Riyahi-Alam S, Derakhshan A, Mansournia M, Mansournia N, Almasi M, Azizi F, Hadaegh F. Blood pressure and cardiovascular morbidity risk in type 2 diabetes with hypertension over a decade of follow-up: evidence for J-shaped phenomenon. Journal of human hypertension. 2017;31(6):415-21. [DOI:10.1038/jhh.2016.94] [PMID]
6. Cesena FH, Nary FC, Santos RD, Bittencourt MS. The contribution of the systolic and diastolic components for the diagnosis of arterial hypertension under the 2017 ACC/AHA Guideline and metabolic heterogeneity among individuals with Stage 1 hypertension. The Journal of Clinical Hypertension. 2020;22(7):1192-9. [DOI:10.1111/jch.13907] [PMID] []
7. Zhou B, Perel P, Mensah GA, Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology. 2021;18(11):785-802. [DOI:10.1038/s41569-021-00559-8] [PMID] []
8. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Annals of internal medicine. 2002;136(7):493-503. [DOI:10.7326/0003-4819-136-7-200204020-00006] [PMID]
9. Bundy JD, Li C, Stuchlik P, Bu X, Kelly TN, Mills KT, et al. Systolic blood pressure reduction and risk of cardiovascular disease and mortality: a systematic review and network meta-analysis. JAMA cardiology. 2017;2(7):775-81. [DOI:10.1001/jamacardio.2017.1421] [PMID] []
10. Al-Mhanna SB, Wan Ghazali WS, Mohamed M, Mohamed RN, Mirza MB, Basheer SN, et al. The Impact of COVID-19 on Physical Activity Patterns of Dental Students: A Multinational Survey. Healthcare (Basel). 2022;10(11). [DOI:10.3390/healthcare10112140] [PMID] []
11. Tanveer M, Asghar E, Tanveer U, Roy N, Zeba A, Al-Mhanna SB, Batrakoulis A. Community-Level Physical Activity Opportunities, Safe and Supportive Environment Factors, and Their Association with Overweight and Obesity Among School-Aged Children and Adolescents in Pakistan-A Cross-Sectional Study. Kurdish Studies. 2024;12(2):6425-32. [DOI:10.3390/sports12090235] [PMID] []
12. Blumenthal JA, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning. Archives of internal medicine. 2000;160(13):1947-58. [DOI:10.1001/archinte.160.13.1947] [PMID]
13. Maciel AW, Pinto LM, Campos RC, Ferreira AC, Dias-Filho CA, Dias CJ, et al. Acute effects of resistance exercise with blood flow restriction in elderly women: A pilot study. Journal of aging and physical activity. 2020;29(3):361-71. [DOI:10.1123/japa.2020-0137] [PMID]
14. Kayhan R, Bayrakdaroğlu S, Ceylan H, Eken Ö, Bayrakdaroğlu Y, Badicu G, et al. Effects of different rest intervals in high intensity interval training programs on VO2max, body composition, and isokinetic strength and power. Journal of Men's Health. 2024;20(5). [DOI:10.22514/jomh.2024.064]
15. Saco‐Ledo G, Valenzuela PL, Ruiz‐Hurtado G, Ruilope LM, Lucia A. Exercise reduces ambulatory blood pressure in patients with hypertension: a systematic review and meta‐analysis of randomized controlled trials. Journal of the American Heart Association. 2020;9(24):e018487. [DOI:10.1161/JAHA.120.018487] [PMID] []
16. Jabbarzadeh Ganjeh B, Zeraattalab-Motlagh S, Jayedi A, Daneshvar M, Gohari Z, Norouziasl R, et al. Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and dose-response meta-analysis of randomized trials. Hypertension Research. 2024;47(2):385-98. [DOI:10.1038/s41440-023-01467-9] [PMID]
17. Edwards JJ, Deenmamode AHP, Griffiths M, Arnold O, Cooper NJ, Wiles JD, Driscoll JM. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. British Journal of Sports Medicine. 2023;57(20):1317. https://doi.org/10.1136/bjsports-2023-107513 [DOI:10.1136/bjsports-2022-106503]
18. Lee J, Vasan RS, Xanthakis V. Association of blood pressure responses to submaximal exercise in midlife with the incidence of cardiovascular outcomes and all‐cause mortality: the Framingham Heart Study. Journal of the American Heart Association. 2020;9(11):e015554. [DOI:10.1161/JAHA.119.015554] [PMID] []
19. Al-Mhanna SB, Rocha-Rodriguesc S, Mohamed M, Batrakoulis A, Aldhahi MI, Afolabi HA, et al. Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation. 2023;15(1):165. [DOI:10.1186/s13102-023-00766-5] [PMID] []
20. Paluch AE, Boyer WR, Franklin BA, Laddu D, Lobelo F, Lee D-c, et al. Resistance exercise training in individuals with and without cardiovascular disease: 2023 update: a scientific statement from the American Heart Association. Circulation. 2024;149(3):e217-e31. [DOI:10.1161/CIR.0000000000001189] []
21. Sundell J. Resistance Training Is an Effective Tool against Metabolic and Frailty Syndromes. Adv Prev Med. 2011;2011:984683. [DOI:10.4061/2011/984683] [PMID] []
22. Banz WJ, Maher MA, Thompson WG, Bassett DR, Moore W, Ashraf M, et al. Effects of resistance versus aerobic training on coronary artery disease risk factors. Experimental biology and medicine. 2003;228(4):434-40. [DOI:10.1177/153537020322800414] [PMID]
23. Grant S, Todd K, Aitchison T, Kelly P, Stoddart D. The effects of a 12-week group exercise programme on physiological and psychological variables and function in overweight women. Public Health. 2004;118(1):31-42. [DOI:10.1016/S0033-3506(03)00131-8] [PMID]
24. Fagard RH, Cornelissen VA. Effect of exercise on blood pressure control in hypertensive patients. European Journal of Preventive Cardiology. 2007;14(1):12-7. [DOI:10.1097/HJR.0b013e3280128bbb] [PMID]
25. Kokkinos PF, Narayan P, Colleran JA, Pittaras A, Notargiacomo A, Reda D, Papademetriou V. Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension. New England Journal of Medicine. 1995;333(22):1462-7. [DOI:10.1056/NEJM199511303332204] [PMID]
26. Maeda S, Tanabe T, Otsuki T, Sugawara J, Iemitsu M, Miyauchi T, et al. Moderate regular exercise increases basal production of nitric oxide in elderly women. Hypertension Research. 2004;27(12):947-53. [DOI:10.1291/hypres.27.947] [PMID]
27. Ruangthai R, Phoemsapthawee J. Combined exercise training improves blood pressure and antioxidant capacity in elderly individuals with hypertension. Journal of Exercise Science & Fitness. 2019;17(2):67-76. [DOI:10.1016/j.jesf.2019.03.001] [PMID] []
28. Collier S, Kanaley J, Carhart R, Frechette V, Tobin M, Hall A, et al. Effect of 4 weeks of aerobic or resistance exercise training on arterial stiffness, blood flow and blood pressure in pre-and stage-1 hypertensives. Journal of human hypertension. 2008;22(10):678-86. [DOI:10.1038/jhh.2008.36] [PMID]
29. Katzmarzyk PT, Leon AS, Wilmore JH, Skinner JS, Rao D, Rankinen T, Bouchard C. Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. Medicine & Science in Sports & Exercise. 2003;35(10):1703-9. [DOI:10.1249/01.MSS.0000089337.73244.9B] [PMID]
30. Figueroa A, Park SY, Seo DY, Sanchez-Gonzalez MA, Baek YH. Combined resistance and endurance exercise training improves arterial stiffness, blood pressure, and muscle strength in postmenopausal women. Menopause. 2011;18(9):980-4. [DOI:10.1097/gme.0b013e3182135442] [PMID]
31. Dimeo F, Pagonas N, Seibert F, Arndt R, Zidek W, Westhoff TH. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension. 2012;60(3):653-8. [DOI:10.1161/HYPERTENSIONAHA.112.197780] [PMID]
32. Ho SS, Dhaliwal SS, Hills A, Pal S. Acute exercise improves postprandial cardiovascular risk factors in overweight and obese individuals. Atherosclerosis. 2011;214(1):178-84. [DOI:10.1016/j.atherosclerosis.2010.10.015] [PMID]
33. Carpio-Rivera E, Moncada-Jiménez J, Salazar-Rojas W, Solera-Herrera A. Acute effects of exercise on blood pressure: a meta-analytic investigation. Arquivos brasileiros de cardiologia. 2016;106:422-33. [DOI:10.5935/abc.20160064] [PMID] []
34. Park S, Kim J, Lee J. Effects of exercise intervention on adults with both hypertension and type 2 diabetes mellitus: a systematic review and meta-analysis. Journal of Cardiovascular Nursing. 2021;36(1):23-33. [DOI:10.1097/JCN.0000000000000651] [PMID]
35. Lopes S, Afreixo V, Teixeira M, Garcia C, Leitao C, Gouveia M, et al. Exercise training reduces arterial stiffness in adults with hypertension: a systematic review and meta-analysis. Journal of hypertension. 2021;39(2):214-22. [DOI:10.1097/HJH.0000000000002619] [PMID]
36. Al-Mhanna SB, Batrakoulis A, Norhayati MN, Mohamed M, Drenowatz C, Irekeola AA, et al. Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Sports Sci Med. 2024;23(2):366-95. [DOI:10.52082/jssm.2024.366] [PMID] []
37. Al-Mhanna SB, Batrakoulis A, Wan Ghazali WS, Mohamed M, Aldayel A, Alhussain MH, et al. Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis. PeerJ. 2024;12:e17525. [DOI:10.7717/peerj.17525] [PMID] []
38. Batrakoulis A. Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases. 2022;10(4). [DOI:10.3390/diseases10040107] [PMID] []
39. Batrakoulis A. Psychophysiological Adaptations to Pilates Training in Overweight and Obese Individuals: A Topical Review. Diseases. 2022;10(4). [DOI:10.3390/diseases10040071] [PMID] []
40. Batrakoulis A. Role of Mind-Body Fitness in Obesity. Diseases. 2022;11(1). [DOI:10.3390/diseases11010001] [PMID] []
41. Kelley GA, Kelley KA, Vu Tran Z. Aerobic exercise and resting blood pressure: a meta‐analytic review of randomized, controlled trials. Preventive cardiology. 2001;4(2):73-80. [DOI:10.1111/j.1520-037X.2001.00529.x] [PMID] []
42. Ross M, Kargl CK, Ferguson R, Gavin TP, Hellsten Y. Exercise-induced skeletal muscle angiogenesis: impact of age, sex, angiocrines and cellular mediators. Eur J Appl Physiol. 2023;123(7):1415-32. [DOI:10.1007/s00421-022-05128-6] [PMID] []
43. MacDonald HV, Johnson BT, Huedo‐Medina TB, Livingston J, Forsyth KC, Kraemer WJ, et al. Dynamic resistance training as stand‐alone antihypertensive lifestyle therapy: a meta‐analysis. Journal of the American Heart Association. 2016;5(10):e003231. [DOI:10.1161/JAHA.116.003231] [PMID] []
44. Iellamo F, Caminiti G, Montano M, Manzi V, Franchini A, Mancuso A, Volterrani M. Prolonged post-exercise hypotension: effects of different exercise modalities and training statuses in elderly patients with hypertension. International journal of environmental research and public health. 2021;18(6):3229. [DOI:10.3390/ijerph18063229] [PMID] []
45. Cardoso Jr CG, Gomides RS, Queiroz ACC, Pinto LG, da Silveira Lobo F, Tinucci T, et al. Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure. Clinics. 2010;65(3):317-25. [DOI:10.1590/S1807-59322010000300013] [PMID] []
46. Roberts CK, Hevener AL, Barnard RJ. Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training. Comprehensive physiology. 2013;3(1):1. [DOI:10.1002/cphy.c110062] [PMID] []
47. Brown MD, Moore GE, Korytkowski MT, McCole SD, Hagberg JM. Improvement of insulin sensitivity by short-term exercise training in hypertensive African American women. Hypertension. 1997;30(6):1549-53. [DOI:10.1161/01.HYP.30.6.1549] [PMID]
48. Huot M, Arsenault BJ, Gaudreault V, Poirier P, Pérusse L, Tremblay A, et al. Insulin resistance, low cardiorespiratory fitness, and increased exercise blood pressure: contribution of abdominal obesity. Hypertension. 2011;58(6):1036-42. [DOI:10.1161/HYPERTENSIONAHA.111.180349] [PMID]
49. Larsen MK, Matchkov VV. Hypertension and physical exercise: The role of oxidative stress. Medicina. 2016;52(1):19-27. [DOI:10.1016/j.medici.2016.01.005] [PMID]
50. Higashi Y, Yoshizumi M. Exercise and endothelial function: role of endothelium-derived nitric oxide and oxidative stress in healthy subjects and hypertensive patients. Pharmacology & therapeutics. 2004;102(1):87-96. [DOI:10.1016/j.pharmthera.2004.02.003] [PMID]
51. Al-Mhanna SB, Batrakoulis A, Mohamed M, Alkhamees NH, Sheeha BB, Ibrahim ZM, et al. Home-based circuit training improves blood lipid profile, liver function, musculoskeletal fitness, and health-related quality of life in overweight/obese older adult patients with knee osteoarthritis and type 2 diabetes: a randomized controlled trial during the COVID-19 pandemic. BMC Sports Sci Med Rehabil. 2024;16(1):125. [DOI:10.1186/s13102-024-00915-4] [PMID] []
52. Al-Mhanna SB, Leão C, Wan Ghazali WS, Mohamed M, Batrakoulis A, Afolabi HA, et al. Impact of Exercise on High-Density Lipoprotein Cholesterol in Adults with Overweight and Obesity: A Narrative Review. Ann Appl Sport Sci. 2024;12(1). [DOI:10.61186/aassjournal.1300]
53. Al-Mhanna SB, Wan Ghazali WS, Batrakoulis A, Alkhamees NH, Drenowatz C, Mohamed M, et al. Impact of Various Types of Exercise on Lipid Metabolism in Patients with Type 2 Diabetes and Concurrent Overweight/Obesity: A Narrative Review. Ann Appl Sport Sci. 2024;12(1). [DOI:10.61186/aassjournal.1324]
54. García-Hermoso A, Alonso-Martinez AM, Ramírez-Vélez R, Izquierdo M. Effects of exercise intervention on health-related physical fitness and blood pressure in preschool children: A systematic review and meta-analysis of randomized controlled trials. Sports medicine. 2020;50:187-203. https://doi.org/10.1007/s40279-020-01259-y [DOI:10.1007/s40279-019-01191-w]
55. Batrakoulis A, Jamurtas AZ, Draganidis D, Georgakouli K, Tsimeas P, Poulios A, et al. Hybrid Neuromuscular Training Improves Cardiometabolic Health and Alters Redox Status in Inactive Overweight and Obese Women: A Randomized Controlled Trial. Antioxidants (Basel). 2021;10(10). [DOI:10.3390/antiox10101601] [PMID] []
56. Batrakoulis A, Jamurtas AZ, Fatouros IG. High-Intensity Interval Training in Metabolic Diseases: Physiological Adaptations. ACSM's Health Fit J. 2021;25(5):54-9. [DOI:10.1249/FIT.0000000000000703]
57. Batrakoulis A, Fatouros IG. Psychological Adaptations to High-Intensity Interval Training in Overweight and Obese Adults: A Topical Review. Sports (Basel). 2022;10(5). [DOI:10.3390/sports10050064] [PMID] []
58. Yang E, Sharma G, Ram V. American and European hypertension guidelines: finding common ground. American Journal of Cardiology. 2019;123(8):1378-82. [DOI:10.1016/j.amjcard.2019.01.009] [PMID]
59. Franklin BA, Thompson PD, Al-Zaiti SS, Albert CM, Hivert M-F, Levine BD, et al. Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective-an update: a scientific statement from the American Heart Association. Circulation. 2020;141(13):e705-e36. [DOI:10.1161/CIR.0000000000000749] [PMID]
60. Sakamoto S. Prescription of exercise training for hypertensives. Hypertension Research. 2020;43(3):155-61. [DOI:10.1038/s41440-019-0344-1] [PMID]
61. Batrakoulis A, Jamurtas AZ, Fatouros IG. Exercise and type II diabetes mellitus: A brief guide for exercise professionals. Strength Cond J. 2022;44(6):64-72. [DOI:10.1519/SSC.0000000000000731]

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