Resistance training in adults with hypertension
Näytönastekatsaukset
21.9.2026
Level of evidence: B
Low- to moderate-intensity resistance training (dynamic and isometric) likely result in systolic blood pressure reductions ranging from −4.3 to −6.6 mmHg for isometric resistance training (IRT) and +0.5 to −6.9 mmHg for dynamic resistance training (DRT) and diastolic blood pressure reductions ranging from −4.5 to −5.5 mmHg for IRT and −1.0 to −5.2 mmHg for DRT.
The certainty of the evidence is limited by study limitations, inconsistency, imprecision 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. Resistance training can be recommended as part of primary and secondary prevention of arterial hypertension. IRT and DRT may be given equal priority as second-line exercise modalities.
| 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 (Consensus document) | 34 meta-analysis including adults (≥18 years) with hypertension | Dynamic resistance training, isometric resistance training vs usual lifestyle or no exercise | Systolic blood pressure; Diastolic blood pressure | Low to 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 dynamic resistance training and isometric resistance training compared to non-exercise control in an RCT setting. | 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. Exercise interventions with duration 3-52 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 | Intervention duration: Mean 14.1 ± 7.9 weeks (range 4 to 48 weeks). Blood pressure measurement setting: Office, home, or ambulatory measurements. Antihypertensive medication use: Trials with BP-lowering medication "as part of the intervention" were excluded, but baseline medication use of participants is not summarized in the main article. |
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 | ||||||
| «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 | Isometric resistance training | 15 trials, number of patients not reported. | NR | N/A | N/A | Mean expected reduction range: -4.3 to -6.6 mmHg |
| Dynamic resistance training | NR | N/A | N/A | Mean expected range +0.5 to −6.9 mmHg (hypertension) | ||
| «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 | Isometric resistance training | 5 trials, number of patients not reported. | NR | N/A | N/A | −6.27 (−9.58 to −2.96) |
| Dynamic resistance training | 11 trials, number of patients not reported. | NR | N/A | N/A | −6.44 (−8.39 to −4.49) | |
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations, imprecision and inconsistency. | ||||||
| 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 | ||||||
| «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 | Isometric resistance training | 15 trials, number of patients not reported. | NR | N/A | N/A | Mean expected range: -4.5 to -5.5 mmHg |
| Dynamic resistance training | NR | N/A | N/A | Mean expected range: −1.0 to −5.2 mmHg (hypertension) | ||
| «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 | Isometric resistance training | 5 trials, number of patients not reported. | NR | N/A | N/A | −3.51 (−5.70 to −1.33) |
| Dynamic resistance training | 11 trials, number of patients not reported. | NR | N/A | N/A | −3.19 (−5.83 to −0.55) | |
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations and inconsistency. | ||||||
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