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Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training On Blood Pressure in Adults with Pre- to Established Hypertension: A Systematic Review and Meta-Analysis of Randomized Trials

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Abstract

Background

Aerobic exercise reduces blood pressure (BP), but it is unknown whether a high-intensity training approach can elicit a greater BP reduction in populations with elevated BP. This systematic review compared the efficacy of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) for reducing BP in adults with pre- to established hypertension.

Methods

Five electronic databases (MEDLINE, EMBASE, CENTRAL, PEDro, and SPORTDiscus) were searched for randomized trials comparing the chronic effects of HIIT versus MICT on BP in individuals with resting systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 85 mmHg and/or under antihypertensive medication. Random-effects modelling was used to compare changes from pre- to post-intervention in resting and ambulatory BP between HIIT and MICT. Changes from pre- to post-intervention in maximal oxygen uptake (\(\dot{V}\)O2max) between HIIT and MICT were also meta-analyzed. Data were reported as weighted mean difference (MD) and 95% confidence interval (CI).

Results

Ambulatory BP was excluded from the meta-analysis due to the limited number of studies (two studies). Comparing changes from pre- to post-intervention, no differences in resting systolic BP (MD − 0.22 mmHg [CI 95%, − 5.36 to 4.92], p = 0.93, I2 = 53%) and diastolic BP (MD − 0.38 mmHg [CI 95%, − 3.31 to 2.54], p = 0.74, I2 = 0%) were found between HIIT and MICT (seven studies; 164 participants). HIIT improved \(\dot{V}\)O2max to a greater magnitude than MICT (MD 2.13 ml/kg/min [CI 95%, 1.00 to 3.27], p < 0.01, I2 = 41%) with similar completion rates of the intervention and attendance at the exercise training sessions (nine studies; 245 participants). Limited data were available to compare the incidence of adverse events between HIIT and MICT.

Conclusion

HIIT and MICT provided comparable reductions in resting BP in adults with pre- to established hypertension. HIIT was associated with greater improvements in \(\dot{V}\)O2max when compared to MICT. Future randomized trials should investigate the efficacy of HIIT versus MICT for reducing ambulatory BP in adults with pre- to established hypertension.

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PROSPERO registration (2016: CRD42016041885).

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Authors and Affiliations

  1. Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil

    Eduardo Caldas Costa

  2. Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada

    Jacqueline L. Hay, Dustin S. Kehler, Kevin F. Boreskie & Todd A. Duhamel

  3. Institute of Cardiovascular Sciences, St-Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada

    Jacqueline L. Hay, Dustin S. Kehler, Kevin F. Boreskie, Rakesh C. Arora & Todd A. Duhamel

  4. National Institute of Science and Technology for Health Technology Assessment (IATS)-CNPq, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    Daniel Umpierre

  5. University of Manitoba Libraries, Winnipeg, MB, Canada

    Andrea Szwajcer

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Correspondence to Eduardo Caldas Costa.

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Funding

Eduardo Caldas Costa and Daniel Umpierre are recipients of research grants from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (476902/2013-4 and 201422/2015-8). Jacqueline Hay is a recipient of the Canadian Institute of Health Research Vanier Scholarship. Dustin Kehler is a recipient of the Canadian Institutes of Health Research Frederick Banting scholarship and the Charles Best Canada Graduate Scholarship. Kevin Boreskie is a recipient of a Manitoba Graduate Scholarship and is supported by the Graduate Enhancement of Tri-Council Stipends program. Todd Duhamel is supported by the Canadian Institutes of Health Research and the Heart and Stroke Foundation.

Conflict of interest

Eduardo Caldas Costa, Jacqueline Hay, Dustin Kehler, Kevin Boreskie, Rakesh Arora, Daniel Umpierre, Andrea Szwajcer, and Todd Duhamel declare that they have no conflicts of interest relevant to the content of this review.

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Costa, E.C., Hay, J.L., Kehler, D.S. et al. Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training On Blood Pressure in Adults with Pre- to Established Hypertension: A Systematic Review and Meta-Analysis of Randomized Trials. Sports Med 48, 2127–2142 (2018). https://doi.org/10.1007/s40279-018-0944-y

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