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Meta-Analysis
. 2024 Jul 2;13(1):169.
doi: 10.1186/s13643-024-02589-y.

Effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women: a systematic review and meta-analysis

Deshuang Yang #  1 , Shiyi Tao #  2 , Mingjing Shao  3 , Li Huang  1 , Xiang Xiao  1 , Jin Zhang  2 , Ruiqi Yao  4 , Ziyi Sun  2
Affiliations
Meta-Analysis

Effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women: a systematic review and meta-analysis

Deshuang Yang et al. Syst Rev. .

Abstract

Background: The acute and long-term benefits of exercise training on cardiovascular health have been well established. The systematic review and meta-analysis aimed to systematically assess the effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women with elevated blood pressure.

Methods: A comprehensive search was conducted on PubMed, Embase, Web of Science, ProQuest, Cochrane Library, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov website from inception to September 30, 2023, to identify the randomized controlled trials (RCTs), which evaluated the effectiveness of exercise training on arterial stiffness and blood pressure in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random/fixed effects models. Quality assessment was performed using the modified Jadad scale and the Cochrane Risk of Bias Tool. Sensitivity analysis and subgroup analysis were conducted based on drug dosage, treatment duration, and age of administration to further explore potential heterogeneity. Funnel plots were performed to assess publication bias and Begg's regression test was carried out for funnel plot asymmetry.

Results: Twenty-two RCTs involving 1978 participants were included in the quantitative analysis. The mean quality of eligible studies was 4.2 out of 7 based on the modified Jadad scale. The results indicated that exercise training had a significant effect on reducing brachial-ankle pulse wave velocity [MD = - 0.69, 95%CI (- 1.11, - 0.27), P = 0.001], decreasing augmentation index (AIx) [MD = - 6.00, 95%CI (- 6.39, - 5.61), P < 0.00001] and AIx normalized to a heart rate of 75 beats per minute (AIx@75%) [MD = - 7.01, 95%CI - 7.91 to - 6.12, P < 0.00001], lowering systolic blood pressure [MD = - 6.19, 95%CI - 9.24 to - 3.15, P < 0.0001], diastolic blood pressure [MD = - 3.57, 95%CI (- 6.10, - 1.03), P = 0.006) and pulse pressure [MD = - 8.52, 95%CI (- 16.27, - 0.76), P = 0.03]. Subgroup analysis revealed that baseline blood pressure levels had a large impact on the effect of exercise training.

Conclusions: The systematic review and meta-analysis suggested that exercise training may ameliorate arterial stiffness and reduce blood pressure in postmenopausal women with elevated blood pressure. However, the optimal mode of exercise training that improves arterial stiffness and blood pressure in this population requires further investigation.

Systematic review registration: PROSPERO CRD42021211268.

Keywords: Arterial stiffness; Exercise training; Hypertension; Postmenopausal women.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study selection process. RCTs, randomized controlled trials. *Industry websites, contact with authors, and trial registries
Fig. 2
Fig. 2
A meta-analysis of the exercise effects on arterial stiffness. A-1 Meta-analysis of all studies, A-2 Mona Mohamed Taha et al. removed baPWV, B AIx, and C AIx@75%
Fig. 3
Fig. 3
A meta-analysis of the exercise effects on SBP. A Meta-analysis of all studies, B subgroup analysis based on baseline SBP
Fig. 4
Fig. 4
A meta-analysis of the exercise effects on DBP. A Meta-analysis of all studies, B subgroup analysis based on baseline DBP
Fig. 5
Fig. 5
A meta-analysis of the exercise effects on PP
Fig. 6
Fig. 6
Risk of bias of included studies
Fig. 7
Fig. 7
Publication Bias assessment of included studies. Begg’s funnel plot pseudo 95% confidence limits of A SBP and B DBP
See this image and copyright information in PMC

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