Effects of Resistance Training on Systolic and Diastolic Blood Pressure in Hypertensive Adults: A Systematic Review...

Background and Objectives: Hypertension is an important clinical condition associated with increased cardiovascular morbidity and mortality. Resistance training has been proposed as a non-pharmacological strategy for blood pressure control; however, its clinical relevance in hypertensive adults remains unclear because of methodological heterogeneity and differences in training prescription. This systematic review and meta-analysis aimed to analyse the effects of resistance training on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults with hypertension or elevated blood pressure, with emphasis on the magnitude of the effects and a cautious interpretation of their clinical relevance. Materials and Methods: A systematic search was conducted in Scopus, PubMed, EBSCOhost and Web of Science from database inception to 1 June 2026. Randomised controlled trials were eligible if they included adults with hypertension or elevated blood pressure, examined resistance training interventions, and reported SBP and DBP values before and after the intervention. Twelve randomised controlled trials were included. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using inverse-variance random-effects models. Results: Resistance training produced a significant reduction in SBP compared with control or comparator groups, with a moderate pooled effect (SMD = -0.77; 95% CI: -1.06 to -0.48; p < 0.00001; I² = 35%). DBP also decreased significantly, with a smaller pooled effect (SMD = -0.43; 95% CI: -0.67 to -0.19; p = 0.0003; I² = 0%). Conclusions: Resistance training reduces SBP and DBP in adults with hypertension or elevated blood pressure. Its clinical application should be considered complementary to pharmacological treatment. Because individual participant data and categorical transition analyses were not available, the current evidence does not confirm systematic reclassification across AHA/ACC blood pressure categories. Standardised protocols and analyses based on absolute blood pressure changes in mmHg are required.