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The effect of exercise training on blood pressure in african and asian populations: a systematic review and meta-analysis of randomized controlled trials

Session Poster Session 1

Speaker Marina Bersaoui

Congress : EuroPrevent 2019

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Poster Session
  • FP Number : P281

Authors : M Bersaoui (Paramaribo,SR), SM Baldew (Paramaribo,SR), N Cornelis (Leuven,BE), J Toelsie (Paramaribo,SR), VA Cornelissen (Leuven,BE)

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Authors:
M Bersaoui1 , SM Baldew1 , N Cornelis2 , J Toelsie1 , VA Cornelissen2 , 1Anton de Kom University of Suriname - Paramaribo - Suriname , 2KU Leuven - Leuven - Belgium ,

Citation:

Background: Current international guidelines recommend exercise as a first line treatment in the prevention and management of hypertension (HT). These recommendations are primarily based on meta-analyses involving data collected in predominantly Caucasian populations. However, in line with the various responses to pharmacological blood pressure (BP) lowering interventions in patients of different ethnic origin, we hypothesize that the change in BP following exercise training might be different in non-Caucasian populations; and thus requiring different exercise prescriptions. However, studies evaluating the efficacy of exercise training as a non-pharmacological intervention in the BP management of non-Caucasian populations are limited and inconclusive.

Purpose: To systematically summarize the available literature on the efficacy of exercise interventions on BP in healthy adults (ageĀ = 18 years) of African- or Asian-origin by means of meta-analytic techniques.

Methods: We conducted a search in three electronic databases and performed a systematic review and meta-analysis of randomized controlled trials investigating the effect of exercise training on BP among African- and Asian-origin adults with optimal BP, high BP or HT as per the latest ACC/AHA guidelines, and published in a peer-reviewed journal up to May 2018. Random effect models were fitted to estimate the effect sizes. We reported data as weighted means and 95% confidence intervals (CI).

Results: We identified 30 studies, involving 25 trials conducted in a population of Asian-origin (n=903; mean age: 44.1 years; 42% male) and 5 trials in a population of African-origin (n=510; mean age: 56.7 years; 80% male). The trials consisted of 17 aerobic, 8 resistance and 5 combined training groups. Overall, significant reductions (p<0.0001) were observed for systolic BP (SBP) and diastolic BP (DBP). Comparison among the ethnic groups showed a significantly larger net change in SBP among the African- population compared to the Asian-origin population (p=0.005), but not for DBP (p=0.95). Endurance training reduced SBP more in the African-origin population (-14.96 vs -5.89 mmHg; p<0.0001), whereas the reduction in DBP was larger in the Asian-origin population (-2.07 vs -5.79 mmHg; p<0.0001). In the subgroup of hypertensive participants (n=1088) significantly larger net change in SBP was observed in the African- compared to the Asian-origin population (p<0.01), but not for DBP (p=0.64).

Conclusions: We found significant different BP responses to aerobic training between the populations of African- and Asian-origin. However, the overall low number of studies performed among the populations of African-origin and the limited data with regard to resistance training in both ethnic groups calls for more research in the field of exercise therapy in non-Caucasian populations.

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