The quality of evidence is downgraded by inconsistency (variability in results and statistical heterogeneity).
Walking 150 minutes per week at moderate intensity is recommended for blood pressure lowering.
The recommendation is strong because walking, in addition to the beneficial effects on blood pressure observed in this review, has many known benefits to both physical and mental well-being, has low costs, and rarely has any harms.
A Cochrane review [Abstract]1 included 73 studies with a total of 5 763 subjects aged from 16 to 84 years from 22 countries. 17 studies (23%) reported that they recruited hypertensive participants, while 15 (21%) reported that they recruited non-hypertensive participants. The majority of walking interventions was at home/community and supervised; the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate.
Walking reduced systolic blood pressure (SBP; MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n=5 060, statistical heterogeneity I2 =53%), diastolic blood pressure (DBP; MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n=4 711, statistical heterogeneity I2 =53%), and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n=1 747, statistical heterogeneity I2 =65%). Walking reduced SBP and DBP in participants aged 40 years and under, in participants aged 41 to 60 years, and those aged 60 years and over. Walking reduced SBP and DBP in both females and males.
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