A meta-analysis 1 http://hyper.ahajournals.org/cgi/content/full/46/4/667 involved randomized controlled trials studying endurance-type training and designed to increase endurance performance. The study populations had to consist of normotensive or hypertensive adults who were otherwise healthy (antihypertensive medication was allowed). The duration of training had to be at least 4 weeks. After a systematic literature search, 72 trials were found for meta-analysis. Of these, 10 trials (11 study groups) used ambulatory blood pressure measurement (ABPM), either by the oscillometric or the auscultatory technique. The total number of participants in these studies or their characteristics are not detailed in the larger meta-analysis 1.
Daytime ambulatory BP (including 2 trials that only reported 24-hour BP) averaged 135/86 mmHg. The exercise-induced weighted net change in BP averaged -3.3 (95% confidence interval [CI] -5.8 to -0.9)/-3.5 (95% CI -5.2 to -1.9). The net change had been calculated by weighing the results in each individual study by the number of participants in the training group.
Comment: The quality of evidence is downgraded by limitations in study quality (limited reporting) and by imprecise results (limited study size for each comparison).
Seven studies assessing endurance-type exercise were qualified for a meta-analysis 1. Each with at least a controlled design (from the years 1989-1993, altogether 137 in the exercise group and 118 were controls. Four studies were randomised. Six studies included hypertensive subjects (no medication). The majority of subjects were men. The principal form of exercise was cycling. The average duration of training was 14 weeks, frequency four times a week and intensity 65% of maximal oxygen consumption.
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