title: The ambulatory hypotensive effect of aerobic training: a reappraisal through a meta-analysis of selected moderators.
abstract: The effectiveness of regular exercise in decreasing both systolic and diastolic blood pressure (BP) is well-established. Our purpose was to assess the impact of both subject and physical activity program characteristics on ambulatory BP through a meta-analysis of the existing literature. Three databases (PubMed, Embase, Web of Science) were searched using relevant terms and strategies. From 637 identified records, 37 studies met inclusion criteria: details about training intervention and participant characteristics, pre- and post-training ambulatory BP measurements, at home (HBPM) or during 24-h (ABPM). The weighted mean difference was for 24-h systolic/diastolic ABPM (n = 847 participants): -4.06/-2.77 mmHg (95%CI: -5.19 to -2.93/-3.58 to -1.97; P < 0.001), for daytime (ABPM or HBPM, n = 983): -3.78/-2.73 mmHg (95%CI: -5.09 to -2.47/-3.57 to -1.89; P < 0.001) and nighttime ABPM periods (n = 796): -2.35/-1.70 mmHg (95%CI: -3.26 to -1.44/-2.45 to -0.95; P < 0.001). Characteristics significantly influencing BP improvement were: an initial office BP ≥130/85 mmHg and diet-induced weight-loss. We found no differences according to sex, age, or training characteristics (intensity, number of sessions, training duration). Antihypertensive effects of aerobic training assessed by ambulatory BP measurements appear significant and clinically relevant for both daytime and nighttime periods, in particular for participants with an office BP ≥130/85 mmHg.
authors.affiliation: Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France.|Cardiology Department, University Hospital of Poitiers, Poitiers, France.|Sports Medicine Centre MON STADE, Paris, France.|Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, QC, Canada.
authors.forename: P
authors.identifier: http://orcid.org/0000-0002-5771-8174
authors.initials: P
authors.lastname: Sosner
authors.affiliation: Inserm UMR1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France.|Cardiovascular and Pulmonary Rehabilitation Center, Clinic of Saint-Orens, Saint-Orens-de-Gameville, France.
authors.forename: T
authors.initials: T
authors.lastname: Guiraud
authors.affiliation: Rehabilitation Department, University Hospital of Dijon, Dijon, France.|Multi-thematic Clinical Investigation Center (CIC-P) Inserm 1432, University Hospital, Dijon, France.|Inserm U1093, Dijon, France.
authors.forename: V
authors.initials: V
authors.lastname: Gremeaux
authors.affiliation: Direction of Libraries, University of Montreal, Montreal, QC, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Arvisais
authors.affiliation: Cardiology Department, University Hospital of Poitiers, Poitiers, France.|Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.
authors.forename: D
authors.initials: D
authors.lastname: Herpin
authors.affiliation: Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France.|Faculty of Sport Sciences, University of Poitiers, Poitiers, France.|Department of Kinesiology, University of Montreal, Montreal, QC, Canada.|Montreal Geriatric Institute, Laboratory LESCA, Montreal, QC, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Bosquet
mesh_terms: D000367:Age Factors; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D004032:Diet; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D012737:Sex Factors; D015431:Weight Loss
keywords: Hypertension; hypotensive; pre-hypertension; training