Abstract
BackgroundHypertension, type 2 diabetes mellitus and cardiovascular disease are among the leading causes of mortality globally. Exercise is one of the commonly recommended interventions/preventions for hypertension, type 2 diabetes mellitus and cardiovascular disease. However, the previous reviews have shown conflicting evidence on the effects of exercise. Our objective is to assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease.MethodsThis protocol for a systematic review was undertaken using the recommendations of The Cochrane Collaboration, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and the eight-step assessment procedure suggested by Jakobsen et al. We plan to include all relevant randomised clinical trials and cluster-randomised trials assessing the effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science Journal Database (VIP) and BIOSIS. We will systematically assess the risks of random errors using Trial Sequential Analysis as well as risks of bias of all included trials. We will create a ‘Summary of Findings’ table in which we will present our primary and secondary outcomes, and we will assess the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).DiscussionThe present systematic review will have the potential to aid patients, clinicians and decision-makers recommending exercise and thereby, benefit patients with hypertension, type 2 diabetes mellitus and/or cardiovascular disease.Systematic review registrationPROSPERO CRD42019142313
Highlights
Hypertension, type 2 diabetes mellitus and cardiovascular disease are among the leading causes of mortality globally
Despite the existence of effective blood pressure lowering drugs and preventive strategies, the burden of hypertension is constantly raising due to unhealthy lifestyle, ageing population [6] enhanced by lack of awareness and insufficient screening, treatment and control [7]
Why do we need this review? We have identified several previous reviews of randomised clinical trials that have assessed the effects of exercise in patients with hypertension, type 2 diabetes mellitus and/or cardiovascular disease but with different conclusions (Table 4)
Summary
Hypertension, type 2 diabetes mellitus and cardiovascular disease are among the leading causes of mortality globally. Exercise is one of the commonly recommended interventions/preventions for hypertension, type 2 diabetes mellitus and cardiovascular disease. Our objective is to assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. Cardiovascular disease is a common term for disorders of the heart or blood vessels which includes cerebrovascular disease, congenital heart disease, rheumatic heart disease, deep vein thrombosis, pulmonary thrombosis, coronary artery disease such as myocardial infarction, and heart failure [8] It is the leading cause of death globally with 17.9 million deaths in 2016 [9]. The risk of cardiovascular disease is high among people with raised blood pressure (hypertension), raised blood glucose level and hyperlipidemia [8]
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