Aerobic exercise in adults with hypertension
Näytönastekatsaukset
21.9.2026
Level of evidence: B
Aerobic exercise likely reduces blood pressure in adults with hypertension compared with a usual lifestyle without structured exercise.
In patients with hypertension, aerobic exercise likely produces a clinically meaningful mean expected blood pressure reduction ranging from -4.9 to -12.0 mmHg systolic and -3.4 to -5.8 mmHg diastolic.
The certainty of the evidence is limited by study limitations, inconsistency and publication bias.
Applicability to clinical practice is good, as exercise interventions are feasible in everyday life and even a sustained reduction of a few mmHg in blood pressure is clinically and population-wise meaningful.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias « Additional comments for included studies»2 |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| «Hanssen H, Boardman H, Deiseroth A, ym. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Ca»1 | Systematic review of meta-analyses (meta-review, consensus document) | 34 meta-analysis including adults (≥18 years) with hypertension | Aerobic training vs usual lifestyle or no exercise. | Systolic blood pressure; Diastolic blood pressure | Moderate |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials. Hy»2 | MA | 84 studies, including 5065 adults (≥18 years) with hypertension. Europe, Asia, North America, Oceania and others | Exercise training modalities including aerobic training and combined training (aerobic plus resistance) compared to non-exercise control. | Systolic blood pressure; Diastolic blood pressure | Moderate |
| Reference | Comments |
|---|---|
| «Hanssen H, Boardman H, Deiseroth A, ym. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Ca»1 | Adults (>18 years), with and without cardiovascular risk factors, across normal BP, high-normal BP, and hypertension categories. Intervention durations 4-52 weeks. Frequency of the training typically 3x/week. Main exclusions (meta-analyses): Focus on specific diseases (eg, type 2 diabetes or chronic kidney disease), children/adolescents only, acute exercise effects, non-randomized trials, neuromotor exercise (eg, Tai Chi, Yoga), unclear cardiovascular effects, morbidity/mortality as primary endpoint. |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials. Hy»2 | Blood pressure measurement setting: Office, home, or ambulatory measurements. Intervention duration: Mean 14.1 ± 7.9 weeks (range 4 to 48 weeks). Exclusion criteria: Trials with BP-lowering medication as part of the intervention. |
Results
| Reference | Mode | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| I=intervention; C=comparison; CI=confidence interval, N/A=not assessed | ||||||
| «Hanssen H, Boardman H, Deiseroth A, ym. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Ca»1 | Aerobic training | 21 meta-analysis | NR | N/A | N/A | Mean expected reduction range −4.9 to −12.0 mmHg |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials. Hy»2 | Aerobic training Combined training | 56 trials, number of patients not reported. 8 trials, number of patients not reported. | NR NR | N/A N/A | N/A N/A | −7.85 (−9.55 to −6.15) −7.64 (−11.70 to −3.57) |
| Level of evidence: moderate The quality of evidence is downgraded due to (inconsistency, publication bias). | ||||||
| Reference | Mode | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| I=intervention; C=comparison; CI=confidence interval, N/A=not assessed | ||||||
| «Hanssen H, Boardman H, Deiseroth A, ym. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Ca»1 | Aerobic training | 21 meta-analysis, total number of patients not reported. | NR | N/A | N/A | expected range −3.4 to −5.8 mmHg |
| «Morita H, Abe M, Suematsu Y, ym. Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials. Hy»2 | Aerobic training Combined training | 56 trials, number of patients not reported. 8 trials, number of patients not reported. | NR NR | N/A N/A | N/A N/A | −4.70 (−5.69 to −3.72) −4.69 (−6.67 to −2.70) |
| Level of evidence: moderate The quality of evidence is downgraded due to (inconsistency, publication bias). | ||||||
References
- Hanssen H, Boardman H, Deiseroth A, ym. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension. Eur J Prev Cardiol 2022;29(1):205-215 «PMID: 33758927»PubMed
- Morita H, Abe M, Suematsu Y, ym. Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials. Hypertens Res 2025;48(2):733-743 «PMID: 39609644»PubMed