Effects of recreational sports and combined training on blood pressure and glycosylated hemoglobin in middle-aged and older adults: a systematic review and meta-analysis

BackgroundCombined resistance and aerobic training (CT) is the most suitable form of exercise training to simultaneously improve cardiometabolic profile and functional capacity in middle-aged and older adults. Recreational sports (RS) emerge as an alternative to traditional exercises to improve these outcomes that could be used as a retention and continuity strategy, promoting health benefits associated with pleasure and satisfaction during the physical activity. ObjectivesThe aim was to conduct a meta-analysis on the effects of RS and CT on systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c) in middle-aged and older adults and to compare these exercise interventions to a non-exercising control group (CON). Data SourcesA literature search was conducted using the databases at PubMed, COCHRANE and SciELO between July and August 2020. Study Eligibility CriteriaStudies that included men and women aged [≥]45 years, healthy or with values of baseline for SBP [≥]130mmHg or DBP [≥]80 mmHg or with type II diabetes, in which the participants performed RS or CT versus CON, and evaluated SBP, DBP and HbA1c. Study Appraisal and Synthesis MethodsTwo independent reviewers screened search results, performed data extraction, and assessed of methodological quality of studies. Random effects modeling was used to compare pre-to post-intervention changes in BP and HbA1c from RS and CT versus CON, and the effect size were calculated through the weighted mean difference (MD) with a 95% confidence interval (CI). ResultsFrom 6017 records, 27 studies were included (9 RS and 18 CT interventions). The analysis included 1411 participants with 55 {+/-} 8 years (range, 45-73 years). Overall, RS was associated reduction in SBP (MD: -7.20 mmHg; CI: -13.7 to -0.7) and DBP (MD: -3.6 mmHg; 95%CI: -6.6 to -0.5) versus CON. CT reduction SBP (MD: -3.6 mmHg; 95%CI: -5.2 to -2.0) and DBP (MD: -3.10 mmHg; 95%CI: -3.75 to -2.44) versus CON. RS not reduced HbA1c (MD: -0.24 %; CI: -0.53 to 0.06) versus CON. However, CT reduced HbA1c (MD: -0.47%; 95%CI: -0.67 to -0.27) versus CON. ConclusionsRS and CT are effective exercise interventions to improve blood pressure in middle-aged and older adults. Additionally, CT seems to be an excellent strategy to reduce HbA1c, and future studies are necessary to confirm the effectiveness of recreational sports to improve HbA1c. Systematic Review Registration NumberCRD42020207250 Key PointsRecreational sports promote similar or even greater blood pressure reduction when compared to traditional exercises. Combined training promotes improvements in blood pressure and HbA1c in aging adults. As alternative to traditional exercises, recreational sports emerge as an effective strategy to improve the cardiometabolic profile in middle-aged and older adults.