The role of exercise in blood pressure control: supportive evidence.

Epidemiological studies suggest an inverse relationship between physical activity or fitness and blood pressure. In controlled intervention studies, the weighted net change in conventional blood pressure caused by dynamic aerobic training averaged -5.3 mmHg for systolic and -4.8 mmHg for diastolic blood pressure. The considerable interstudy variation in the blood pressure response can be partly explained by the more pronounced effect in hypertensive patients compared with the results in normotensive subjects. When only studies that used a random procedure and some follow-up study of the controls were included, the blood pressure-lowering effect of training was significant only in hypertensives. The same pattern is emerging for daytime blood pressure in studies that applied ambulatory pressure monitoring: night-time pressure was usually not affected by training. In conclusion, despite shortcomings in many individual studies, the overall results suggest that dynamic aerobic training may lower conventional and daytime blood pressure in adults with elevated blood pressure at baseline.