Brief Report: Exercise and Blood Pressure in Older Adults-An Updated Look.

George A. Kelley,Kristi S. Kelley

doi:10.1155/2018/6548659

George A. Kelley, Kristi S. Kelley

Open Access

https://doi.org/10.1155/2018/6548659

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Abstract

Background/Objectives Raised blood pressure is a major problem in older adults. Using a random-effects model, a recent meta-analysis reported statistically significant reductions in both resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) as a result of aerobic, resistance, and combined aerobic and resistance exercise in adults ≥65 years. To provide more objective information regarding this nonpharmacologic approach, this study applied more robust methods to this data. Design Meta-analysis of 41 randomized controlled trials representing 96 groups (52 exercise; 44 control). Setting Any location where a randomized controlled trial could be conducted. Participants Adults ≥65 years. Intervention Trials ≥2 weeks that included aerobic, resistance, and/or combined aerobic and resistance exercise as the intervention. Measurements The recently developed inverse heterogeneity model (IVhet) was used to pool findings and the Doi plot was used to examine for small-study effects. Absolute and relative differences between the IVhet and random-effects model were also calculated. Data were reported using the mean difference (exercise minus control) with nonoverlapping 95% confidence intervals considered statistically significant. Results Statistically significant reductions in resting blood pressure were found as a result of aerobic exercise (SBP, -4.7 mmHg, 95% CI, -7.7 to -1.8; DBP, -2.0 mmHg, 95% CI -3.13 to -0.9), SBP but not DBP for resistance training (SBP, -7.0 mmHg, 95% CI, -10.5 to -3.4; DBP, -1.2 mmHg, 95% CI -2.7 to 0.3), and both SBP and DBP for combined aerobic and resistance training (SBP, -5.5 mmHg, 95% CI, -8.3 to -2.7; DBP, -3.7 mmHg, 95% CI -4.8 to -2.7). Conclusions Exclusive of changes in DBP congruent with resistance training, exercise (aerobic, resistance, and combined aerobic and resistance) reduces resting SBP and DBP in older adults. These findings have practical implications when considering exercise for the prevention and treatment of raised blood pressure in older adults.

Highlights

Raised blood pressure, defined as a resting systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg, is a major risk factor for cardiovascular morbidity and mortality [1] and is especially prevalent among older adults [2]
Data for this brief communication were derived from a recent systematic review with meta-analysis focused on the effects of exercise on any level of resting SBP and DBP in older adults, details of which have been described elsewhere [4]
A summary of changes in resting SBP and DBP using the inverse heterogeneity model (IVhet) model is shown in Table 1, study-level results are shown in Supplementary Files 1-6, and Doi plots for asymmetry, i.e., small-study effects, are shown in Table 2, Figure 1, and Supplementary Files 7-11

Summary

Introduction

Raised blood pressure, defined as a resting systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg, is a major risk factor for cardiovascular morbidity and mortality [1] and is especially prevalent among older adults [2]. In adults 60 years of age and older, the worldwide prevalence of raised blood pressure has been reported to be 44.1%, 47.8%, 50.3%, 51,7%, 51.6%, and 50.2%, respectively, in men 60-64, 65-69, 70-74, 75-79, 80-84, and 85+ years of age [2]. Using a random-effects model, a recent meta-analysis by Herrod et al (2018) reported statistically significant reductions in both resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) as a result of aerobic, resistance, and combined aerobic and resistance exercise in adults with a mean age of 65 years and older [4].

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