Effects of dynamic resistance training on blood pressure across different baseline levels: a systematic review and...

This study aimed to systematically evaluate the effects of dynamic resistance training (DRT) on populations with varying baseline blood pressure (BP) levels, compare the commonalities and differences across subgroups, and explore potential sources of heterogeneity.

A systematic literature search of databases including PubMed, Embase, the Cochrane Library, and Web of Science was conducted from inception to January 2026. Randomized controlled trials (RCTs) investigating DRT as the intervention and resting BP as the outcome were included. A random-effects model was employed to calculate the pooled mean differences (MDs) and 95% confidence intervals (CIs). Subgroup analyses were performed based on baseline BP classifications and antihypertensive medication status, while meta-regression was used to assess the moderating effect of age. The Risk of Bias 2 (RoB 2) tool was used to assess the risk of bias, and the certainty of evidence was evaluated using the GRADE approach.

Eighteen studies were ultimately included in this meta-analysis. For systolic blood pressure (SBP), 18 studies comprising 27 effect sizes and 328 participants were pooled, revealing a significant reduction following DRT (MD = -7.57 mmHg; 95% CI: [-9.40, -5.74]; p < 0.001). For diastolic blood pressure (DBP), 17 studies comprising 26 effect sizes and 313 participants were analyzed, also demonstrating a significant reduction (MD = -4.73 mmHg; 95% CI: [-6.41, -3.05]; p < 0.001). Subgroup analyses revealed varying magnitudes of BP reduction among participants with different baseline BP levels. For SBP, the stage 2 hypertension subgroup exhibited the greatest reduction (MD = -9.33 mmHg), followed by the high-normal (MD = -6.17 mmHg) and normal BP subgroups (MD = -5.16 mmHg). For DBP, the stage 1 hypertension subgroup experienced the most significant benefit (MD = -8.82 mmHg). Furthermore, unmedicated participants showed a greater reduction in SBP (MD = -10.06 mmHg) compared to medicated individuals (MD = -6.46 mmHg), whereas DBP reductions were highly consistent between the two groups. Meta-regression analysis indicated that age had no significant moderating effect on the BP-lowering efficacy.

DRT significantly lowers BP in adults, with the magnitude of reduction varying across different baseline levels, generally demonstrating a trend where higher baseline BP yields greater antihypertensive benefits. DRT can be prioritized as a non-pharmacological intervention for patients with stage 2 hypertension. However, given the current limited certainty of evidence and high inter-study heterogeneity, these findings warrant further verification through high-quality RCTs.

https://www.crd.york.ac.uk/PROSPERO/myprospero, PROSPERO CRD420261332947.