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. 2020 Dec 5;9(24):e018487. doi: 10.1161/JAHA.120.018487

Table 1.

Main Characteristics of the Included Studies

Study Participants (Sample Size and Mean Age) Exercise Intervention Criteria to Define Hypertension Antihypertensive Treatment Main Effects on ABP

Barroso et al 34

  1. CT: n=24 (≈66 y)

  2. CG: n=21 (≈70 y)

  1. Modality: RT+MICT

  2. Total duration: 6 mo

  3. Frequency: 3 sessions/wk

  4. Duration per session: 60 min

  5. Intensity: 60%–75% of MHR 50%–60% of 1RM)

 Office SBP/DBP ≥140/90 mm Hg after no drug treatment for ≥2 wk No (drug washout before the study of 2 wk)

  1. No significant changes in 24‐h ABP
Bertani et al 21

  1. MICT: n=15 (≈67 y)

  2. AIT: n=15 (≈68 y)

  3. RT: n=16 (≈67 y)

  4. CG: n=15 (≈66 y)
  • 1

    Modality: MICT, AIT, RT

  • 2

    Total duration: 12 wk

  • 3

    Frequency: 3 sessions/wk

  • 4

    Duration per session: MICT, 20 min.

AIT, alternating high and low‐intensity each 2 min for 20 min

RT, 2 sets of 6–10 repetitions for 9 exercises

  • 5

    Intensity: MICT: 70% of MHR

AIT: 60%–80% of MHR

RT: 75% of 1RM

"Hypertensives taking medication" (no other specification)

 Yes

  1. No significant changes in 24‐h ABP

Blumenthal et al 22

ET: n=54 (≈46 y)

CG: n=24 (≈47 y)

  1. Modality: MICT

  2. Total duration: 6 mo

  3. Frequency: 3–4 times/wk

  4. Duration per session: 35 min

  5. Intensity: 70%–85% of HRR

"Unmedicated high normal BP" or stage 1–2 hypertension (mean office SBP 130–180 mm Hg and/or mean office DBP 85–110 mm Hg)

 No (drug washout before the study for at least 6 wk)

  1. Significant reduction in daytime SBP/DBP
Blumenthal et al 23

ET: n=41 (≈54 y)

RT+flexibility: n=35 (≈46 y)

CG: n=23 (≈45 y)

  1. Modality MICT; RT (weight circuit)+flexibility

  2. Total duration: 4 mo

  3. Frequency: 2–3 times/wk

  4. Duration per session: 35–50 min

  5. Intensity: 70% of VO2max

Office SBP 140–180 mm Hg or office DBP 90–105 mm Hg

 No (drug washout before the study of 4 wk)

  1. No significant changes in daytime ABP
Brito et al 44

ET: n=15 (≈51 y)

MT: n=15 (≈49 y)

CG: n=20 (≈50 y)

  1. Modality: MICT (either in the morning [MT] or the evening [ET])

  2. Total duration: 10 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: 30–45 min

  5. Intensity: increasing from ≈100% of anaerobic threshold to 90% of RCP

Office SBP <160 mm Hg and office DBP <105 mm Hg while receiving anti‐hypertensive drugs for ≥4 mo

 Yes

  1. Significant reduction in 24‐h and daytime DBP with ET, but not with MT

Dimeo et al 30

  1. AIT: n=24 (≈62 y)

  2. CG: n=26 (≈67 y)

  1. Modality: AIT

  2. Total duration: 8–12 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: 30–36 min, including intervals of 3–15 min interspersed with 3‐min walking intervals

  5. Intensity: aerobic threshold

 RH (ie, defined as office SBP/DBP ≥140/90 mm Hg in spite of concurrent use of 3 anti‐hypertensive drugs of different classes or a BP that is controlled with ≥4 anti‐hypertensive drugs) Yes

  1. AIT reduced daytime and 24‐h SBP/DBP

  2. The effects on nighttime SBP and DBP did not reach statistical significance

Farah et al 26

  1. Home‐based IT: n=24

  2. Supervised IT: n=24

  3. CG: n=24

Age range, ≈58–61 y

  1. Modality: RT (handgrip exercise)

  2. Total duration: 12 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: four 2‐min contractions interspersed with 1‐min rests

  5. Intensity: 30% of MVC

 "Use of anti‐hypertensive medications" Yes

  1. No significant changes in ABP
Guimaraes et al 33

  1. CT: n=16 (≈55 y)

  2. CG: n=16 (≈52 y)

  1. Modality: CT (callisthenic exercises+walking in a heated [30°C–32°C] swimming pool

  2. Total duration: 12 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: 50 min

  5. Intensity: 11–13 Borg Scale

 RH for >5 y with unchanged or regular use of 3 anti‐hypertensive drugs in the past 3 mo, with an office SBP/DBP ≥140/90 mm Hg Yes

  1. CT reduced 24‐h, daytime, and nighttime SBP/DBP

Guimaraes et al 28

  1. CT+AIT: n=26

  2. CT+MICT: n=26

  3. CG: n=13

Age range, ≈45–50 y

  1. Modality: CT (MICT or AIT+RT)

  2. Total duration: 16 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: 60 min (40 min of aerobic training+20 min of RT)

  5. Intensity: MICT, 60% of HRR

AIT: alternating 2 min at 50% and 1 min at 80% of HRR

RT: submaximal strength training

 Hypertensive subjects on anti‐hypertensive medication with "controlled" office BP (SBP <140 mm Hg and DBP <90 mm Hg) Yes

  1. No significant changes in ABP
Lima et al 24

  1. MICT: n=15

  2. CT: n=15

  3. CG: n=14

Age range, ≈67–69 y

  1. Modality: MICT (treadmill). CT (MICT+RT)

  2. Total duration: 10 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: MICT=20–30 min; CT=same as MICT plus 9 RT exercises (15–20 repetitions, with 1‐min rests).

  5. Intensity: MICT (NS); RT=50–60% of 1RM

 People regularly using anti‐hypertensive medication (hydrochlorothiazide, ACE inhibitors or ARB), with office SBP <160 mm Hg and office DBP <105 mm Hg) Yes

  1. MICT and CT had a similar significant lowering effect on 24‐h, daytime, and nighttime SBP/DBP

Molmen ‐Hansen et al 49

  1. HIIT: n=31 (≈52 y)

  2. MICT: n=28 (≈53 y)

  3. CG: n=29 (≈51 y)

  1. Modality: AIT, MICT

  2. Total duration: 12 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: MICT (47 min/session). AIT (37 min/session)

  5. Intensity: MICT (70% of MHR).

AIT 4×4 min intervals 85%–90% of MHR, with 3 min at 60%–70% of MHR

Essential

hypertension stage 1–2, defined as office SBP 140–179 mm Hg and/or office DBP 90–109 mm Hg

 No (drug washout before the study of 4 wk)

  1. All training groups showed reductions in 24‐h BP

  2. Daytime SBP/DBP was reduced in both training groups

  3. Nighttime SBP/DBP was reduced in HIIT group
Motlagh et al 20

  1. MICT: n=39 (≈54 y)

  2. CG: n=39 (≈53 y)

  1. Modality: MICT

  2. Total duration: 12 wk

  3. Frequency: 5 sessions/wk

  4. Duration per session: 30 min

  5. Intensity: 40%–60% of MHR

 Diagnosed with primary hypertension, with an office SBP <170 mm Hg and taking ≥1 anti‐hypertensive medication Yes

  1. MICT reduced 24‐h SBP and DBP

Pagonas et al 29

  1. AIT: n=36 (≈65 y)

  2. CG: n=36 (≈67 y)

  1. Modality: AIT

  2. Total duration: 8‐ to 12‐wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: 30–36 min including intervals of varying duration

  5. Intensity: aerobic threshold

Patients under anti‐hypertension

treatment with ≥1 anti‐hypertensive drug and/or office SBP/DBP ≥140/90 mm Hg

 Yes

  1. AIT reduced daytime SBP and DBP

  2. No effects on nighttime SBP or DBP
Stiller‐Moldovan et al 32

  1. RT: n=13

  2. CG: n=12

Age range, ≈60–62 y

  1. Modality: RT (handgrip exercise)

  2. Total duration: 8 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: four 2‐min contractions interspersed with 1‐min rests

  5. Intensity: 30% of MVC

 Individuals medicated for hypertension for ≥4 mo Yes

  1. No significant changes in ABP

Westhoff et al 31

  1. AIT: n=24 (≈67 y)

  2. CG: n=27 (≈68 y)

  1. Modality: AIT

  2. Total duration: 12 wk

  3. Frequency: 3 sessions/wk

  4. Duration per session: 30–36 min including intervals of varying duration

  5. Intensity: aerobic threshold

 Current anti‐hypertension treatment, ambulatory DBP ≤90 mm Hg Yes

  1. AIT reduced 24‐h SBP and DBP

  2. AIT reduced daytime and nighttime SBP/DBP

1RM indicates one maximum repetition; ABP, ambulatory blood pressure; ACE, angiotensin‐converting enzyme; AIT, aerobic interval training; ARB, angiotensin receptor blockers; BP, blood pressure; CG, control group; CT, combined training; DBP, diastolic blood pressure; ET, evening training; HIIT, high‐intensity interval training; HRR, heart rate reserve; IT, isometric handgrip training; MT, morning training; MHR, maximum heart rate; MICT, moderate‐intensity continuous training; MVC, maximal voluntary contraction; RCP, respiratory compensation point; RH, resistant hypertension; RHR, reserve heart rate; RT, resistance training; SBP, systolic blood pressure; and VO2max, maximal oxygen uptake.