Exercise interventions for the effect of endothelial function in hypertensive patients: A systematic review and meta-analysis.

Abstract

Endothelial dysfunction is crucial factor to the hypertension occurrence, and controversy remains regarding the effect of exercise on improving endothelial function in hypertensive patients. The authors used meta-analysis to evaluate the intervention effect of exercise on endothelial function in hypertensive patients and to investigate exercise protocols that may have a greater intervention effect. A total of 37 studies and a total of 2801 participants were included. The results were as follows: endogenous nitric oxide (NO)[SMD=.89, 95% CI (.48, 1.30), p<.0001], endothelin-1 (ET-1): [SMD=-.94, 95% CI (-1.15, -.73), p<.0001], flow-mediated dilation (FMD) [SMD=-.57, 95% CI (.36,.79), p<.000001]. In subgroup analysis, high-intensity aerobic exercise, with a single exercise duration of 35-50min, 3-4 times/week for a total of 10-12weeks, had the largest amount of intervention effect on NO, and moderate-intensity resistance exercise, with a single exercise duration of ≥60min, 6 times/week for a total of 15-18weeks, had the largest amount of intervention effect on ET-1. In conclusion, exercise can improve NO levels, FDM levels, and reduce ET-1 secretion of hypertension patients, thereby improve their endothelial function. The ideal intervention effect of improving NO level was more likely to be obtained by taking the exercise prescription of high-intensity aerobic exercise with a single exercise duration of 35-50min, 3-4 times/week for 10-12weeks; the ideal intervention effect of improving ET-1 was more likely to be obtained by taking the exercise prescription of oderate -intensity resistance exercise with a single exercise duration of ≥60min, 6 times/week for 15-18weeks.