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Network meta-analysis shows exercise modalities reduce blood pressure in adults with prehypertension or hypertensionCombined training and high-intensity interval training lower blood pressure in adults with prehypertension and hypertension

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Key Takeaway
Consider exercise modalities for blood pressure reduction in adults with prehypertension or hypertension.

This network meta-analysis evaluates the efficacy of different exercise modalities for lowering blood pressure in adults with prehypertension and established hypertension. The analysis pooled data from 105 randomized controlled trials to compare interventions such as combined training, high-intensity interval training, yoga, tai chi, aerobic exercise, isometric exercise training, and resistance training against a comparator that was not reported in the source data.

Key findings indicate that combined training resulted in a systolic blood pressure reduction of -12.05 mm Hg with a 95% CrI of -15.08 to -9.05. Diastolic blood pressure reduction for combined training was -6.20 mm Hg with a 95% CrI of -7.79 to -4.62. High-intensity interval training showed a systolic reduction of -10.97 mm Hg with a 95% CrI of -14.97 to -6.95 and a diastolic reduction of -6.42 mm Hg with a 95% CrI of -8.68 to -4.16.

Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. The authors do not overstate certainty regarding these modalities as the primary outcome was systolic and diastolic blood pressure reduction. Practice relevance is suggested but specific recommendations are not detailed in the provided text.

High blood pressure is a silent threat that damages the heart and blood vessels over time. A massive analysis of 105 randomized controlled trials now offers clear guidance on how to fight it. The research looked at adults living with prehypertension or established hypertension. It compared different ways to move the body to see which ones best lowered blood pressure numbers.

Combined training emerged as the most effective approach. This method mixes different types of movement to get the best results. Participants who followed this plan saw their systolic blood pressure drop by 12.05 mm Hg. Their diastolic blood pressure also fell by 6.20 mm Hg. These numbers represent a meaningful reduction that can lower the risk of heart disease.

High-intensity interval training also showed strong results. This style involves short bursts of hard effort followed by rest. People doing this routine saw their systolic pressure drop by 10.97 mm Hg. Diastolic pressure fell by 6.42 mm Hg. The study did not report any safety concerns or side effects for these exercise groups.

The certainty of these findings is high because the data comes from many different trials. However, the study did not report on long-term safety or how well people kept up with these routines. Still, the evidence suggests that moving your body is a proven way to manage blood pressure without relying solely on medication.

What this means for you:
Combined training and high-intensity interval training significantly lower blood pressure in adults with prehypertension or hypertension.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
Exercise interventions can effectively reduce blood pressure (BP), but the optimal exercise modality and dose remain unclear. This study aimed to compare the effects of different exercise modalities and doses on systolic and diastolic BP using Bayesian network meta-analysis and dose-response modeling. Randomized controlled trials published up to April 2025 were searched, and a total of 105 randomized controlled trials were included. A random-effects model was applied to conduct both the network meta-analysis and dose-response analysis. Combined training and high-intensity interval training produced the most significant reductions in BP. Combined training reduced systolic BP by -12.05 mm Hg (95% CrI, -15.08 to -9.05) and diastolic BP by -6.20 mm Hg (95% CrI, -7.79 to -4.62), while high-intensity interval training reduced systolic BP by -10.97 mm Hg (95% CrI, -14.97 to -6.95) and diasatolic BP by -6.42 mm Hg (95% CrI, -8.68 to -4.16). Yoga and tai chi had moderate effects, whereas aerobic exercise, isometric exercise training, and resistance training showed relatively weaker effects. Dose-response analysis revealed a nonlinear U-shaped relationship, with the greatest benefit observed at ≈830 metabolic equivalents/min per wk, and the optimal doses varied by exercise modality. All exercise modalities can significantly reduce BP levels in individuals with prehypertension and established hypertension, and there is a nonlinear dose-response relationship between exercise volume and BP levels.
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