Physical Exercise and Angiotensin II Receptors: A Systematic Review

Background: A functional balance between angiotensin II receptors (AT1R/AT2R) is associated with the regulation of cardiovascular, inflammatory, and tissue remodeling processes. Interventions that promote this balance have a significant impact on quality of life. Physical exercise stands out among these interventions, as the literature extensively identifies it as a therapeutic tool for managing conditions linked to the main axis of the renin-angiotensin system (RAS). Despite its beneficial role regarding the RAS, its effects on AT1R and AT2R receptor expression have not yet been systematically synthesized. Objective: To review the literature and systematically compile existing knowledge regarding the effect of physical exercise on the expression of angiotensin II receptors (AT1R and AT2R) within the RAS. Methods: This is a systematic review registered in PROSPERO (CRD420251267388). Searches were conducted in the PubMed/MEDLINE, PEDro, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, and Scopus databases. Risk of bias was assessed using the RoB 2 and SYRCLE tools. A total of 724 studies were identified, of which 11 met the eligibility criteria: 10 conducted using experimental animal models and 1 involving humans. Results: Eleven studies were included, predominantly animal experimental models. The findings indicate that chronic cyclic physical exercise is associated with reduced AT1R expression and increased AT2R expression in different tissues. In contrast, the only study that evaluated resistance exercise showed a distinct physiological response, with increased AT1R expression. Conclusions: The results suggest that chronic cyclical physical exercise promotes an increase in AT2R receptor expression and a reduction in AT1R expression in various body tissues, although the evidence is derived primarily from animal studies.