Exercise and other nonpharmacological strategies to reduce blood pressure in older adults: a systematic review and meta-analysis

Abstract Background The incidence of hypertension increases with advancing age and represents a significant burden of disease. Lifestyle modification represents the first line intervention in treatment algorithms, however the majority of evidence for this comes from studies involving young participants utilising interventions that may not always be feasible in the elderly. Methods This manuscript presents a systematic review of all randomised controlled trials involving participants with a mean age of 65 or over investigating non-pharmacological strategies to reduce blood pressure (BP). Results Fifty-three randomised controlled trials were included. The majority of interventions described either aerobic (AET), resistance (RET) or combined exercise training (COM), with limited studies reporting isometric training (IET) or alternative lifestyle strategies. AET, RET, COM and IET all elicited significant reductions in both systolic and diastolic BP, with no additional benefit of COM compared to single modality exercise training. Conclusion Three months of traditional exercise-based lifestyle intervention may produce a reduction in BP of approximately 5mmHg systolic and 3mmHg diastolic in older individuals, similar to that expected in younger individuals