Exercise reduces blood pressure after stroke or TIA: systematic review and meta-analysis
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Key Takeaway
Consider prescribing aerobic or combined exercise to reduce blood pressure in patients after stroke or TIA.
This systematic review and meta-analysis of 25 studies examined the effect of exercise on blood pressure in individuals after stroke or transient ischemic attack. The interventions included aerobic, resistance, and combined aerobic and resistance training. The primary outcomes were systolic and diastolic blood pressure reductions.
Aerobic exercise alone reduced systolic blood pressure by 3.79 mmHg (95% CrI: -5.95, -1.86) and diastolic blood pressure by 1.91 mmHg (95% CrI: -3.56, -0.33). Combined aerobic and resistance training produced larger reductions: systolic blood pressure decreased by 7 mmHg (95% CrI: -10.05, -3.87) and diastolic by 3.58 mmHg (95% CrI: -6.04, -1.23).
The authors note that these findings support evidence-based exercise prescriptions for blood pressure management in this high-risk population. However, limitations such as potential heterogeneity among studies and lack of reported adverse events should be considered. The meta-analysis provides quantitative estimates that can guide clinical recommendations, but individual patient factors and exercise tolerance must be taken into account.
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View Original Abstract ↓
OBJECTIVE: This study aimed to examine the dose-response relationships between different exercise modalities and blood pressure reduction in individuals after stroke or transient ischemic attack METHODS: Searches were performed in PubMed (1946), Web of Science (1975), Cochrane CENTRAL (1992), and EMBASE (1971) from inception up to December 10, 2025. Exercise dose was calculated as the product of duration, frequency, and intensity, expressed in metabolic equivalents of task minutes per week (METs-min/week).
RESULTS: A total of 25 studies were included in the review. Aerobic exercise produced the greatest reductions in systolic blood pressure (SBP) at 590 METs-min/week (-3.79 mmHg, 95% CrI: -5.95, -1.86) and diastolic blood pressure (DBP) at 520 METs-min/week (-1.91 mmHg, 95% CrI: -3.56, -0.33). For combined aerobic and resistance training, the optimal doses were 780 METs-min/week for SBP (-7 mmHg, 95% CrI: -10.05, -3.87) and 660 METs-min/week for DBP (-3.58 mmHg, 95% CrI: -6.04, -1.23). Relative ranking analyses indicated that combined aerobic and resistance training at 780 METs-min/week and 660 METs-min/week produced the greatest reductions in SBP and DBP, respectively.
CONCLUSIONS: These findings support evidence-based exercise prescriptions for blood pressure management in this high-risk population.
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