title: Is Concurrent Training Efficacious Antihypertensive Therapy? A Meta-analysis.
abstract: : Aerobic exercise training and, to a lesser degree, dynamic resistance training, are recommended to lower blood pressure (BP) among adults with hypertension. Yet the combined influence of these exercise modalities, termed concurrent exercise training (CET), on resting BP is unclear.
  
  
  
  This study aimed to meta-analyze the literature to determine the efficacy of CET as antihypertensive therapy.
  
  
  
  Electronic databases were searched for trials that included the following: adults (>19 yr), controlled CET interventions, and BP measured pre- and postintervention. Study quality was assessed with a modified Downs and Black Checklist. Analyses incorporated random-effects assumptions.
  
  
  
  Sixty-eight trials yielded 76 interventions. Subjects (N = 4110) were middle- to older-age (55.8 ± 14.4 yr), were overweight (28.0 ± 3.6 kg·m), and had prehypertension (systolic BP [SBP]/diastolic BP [DBP] = 134.6 ± 10.9/80.7 ± 7.5 mm Hg). CET was performed at moderate intensity (aerobic = 55% maximal oxygen consumption, resistance = 60% one-repetition maximum), 2.9 ± 0.7 d·wk for 58.3 ± 20.1 min per session for 19.7 ± 17.8 wk. Studies were of moderate quality, satisfying 60.7% ± 9.4% of quality items. Overall, CET moderately reduced SBP (db = -0.32, 95% confidence interval [CI] = -0.44 to -0.20, -3.2 mm Hg) and DBP (db = -0.35, 95% CI = -0.47 to -0.22, -2.5 mm Hg) versus control (P < 0.01). However, greater SBP/DBP reductions were observed among samples with hypertension in trials of higher study quality that also examined BP as the primary outcome (-9.2 mm Hg [95% CI = -12.0 to -8.0]/-7.7 mm Hg [95% CI = -14.0 to -8.0]).
  
  
  
  Among samples with hypertension in trials of higher study quality, CET rivals aerobic exercise training as antihypertensive therapy. Because of the moderate quality of this literature, additional randomized controlled CET trials that examine BP as a primary outcome among samples with hypertension are warranted to confirm our promising findings.
authors.affiliation: 1Department of Kinesiology, University of Connecticut, Storrs, CT; 2Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, Storrs, CT; 3Department of Kinesiology, The University of Alabama, Tuscaloosa, AL; 4Department of Psychological Sciences, University of Connecticut, Storrs, CT; 5Instituto de Educação Física e Desportos, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, BRAZIL; 6Henry Low Heart Center, Department of Cardiology, Hartford Hospital, Hartford, CT.
authors.forename: Lauren M L
authors.initials: LM
authors.lastname: Corso
authors.forename: Hayley V
authors.initials: HV
authors.lastname: Macdonald
authors.forename: Blair T
authors.initials: BT
authors.lastname: Johnson
authors.forename: Paulo
authors.initials: P
authors.lastname: Farinatti
authors.forename: Jill
authors.initials: J
authors.lastname: Livingston
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Zaleski
authors.forename: Adam
authors.initials: A
authors.lastname: Blanchard
authors.forename: Linda S
authors.initials: LS
authors.lastname: Pescatello
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D058246:Prehypertension / Q000503:physiopathology / Q000628:therapy*; D055070:Resistance Training