Progressive resistance exercise and resting blood pressure : A meta-analysis of randomized controlled trials

Hypertension is a major public health problem affecting an estimated 43 million civilian, noninstitutionalized adults in the United States (24% of this population). The purpose of this study was to use the meta-analytic approach to examine the effects of progressive resistance exercise on resting systolic and diastolic blood pressure in adult humans. Studies were retrieved via (1) computerized literature searches, (2) cross-referencing from original and review articles, and (3) review of the reference list by 2 experts on exercise and blood pressure. Inclusion criteria were as follows: (1) trials that included a randomized nonexercise control group; (2) progressive resistance exercise as the only intervention; (3) adult humans; (4) journal articles, dissertations, and masters theses published in the English-language literature; (5) studies published and indexed between January 1966 and December 1998; (6) resting systolic and/or diastolic blood pressure assessed; and (7) training studies lasting a minimum of 4 weeks. Across all designs and categories, fixed-effects modeling yielded decreases of approximately 2% and 4% for resting systolic and diastolic blood pressure, respectively (mean+/-SD systolic, -3+/-3 mm Hg; 95% bootstrap CI, -4 to -1 mm Hg; mean+/-SD diastolic, -3+/-2 mm Hg; 95% bootstrap CI, -4 to -1 mm Hg). It was concluded that progressive resistance exercise is efficacious for reducing resting systolic and diastolic blood pressure in adults. However, a need exists for additional studies that limit enrollment to hypertensive subjects as well as analysis of data with an intention-to-treat approach before the effectiveness of progressive resistance exercise as a nonpharmacological intervention can be determined.