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Aerobic exercise interventions reduce blood pressure in patients after stroke or transient ischaemic attack: a systematic review and meta-analysis.

Authors
  • Wang, Cheng1
  • Redgrave, Jessica2
  • Shafizadeh, Mohsen3
  • Majid, Arshad1, 4
  • Kilner, Karen5
  • Ali, Ali N1, 6
  • 1 Faculty of Medicine Dentistry and Health, University of Sheffield, Sheffield, UK.
  • 2 Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • 3 Sheffield Hallam University, Academy of Sport and Physical Activity, Sheffield, UK.
  • 4 Sheffield NIHR Biomedical Research Centre, Sheffield, UK.
  • 5 Sheffield Hallam University, Centre for Health and Social Care Research, Sheffield, UK.
  • 6 Sheffield Teaching Hospitals NHS Foundation Trust, Geriatrics and Stroke Medicine, Sheffield, UK.
Type
Published Article
Journal
British Journal of Sports Medicine
Publisher
BMJ
Publication Date
Dec 01, 2019
Volume
53
Issue
24
Pages
1515–1525
Identifiers
DOI: 10.1136/bjsports-2017-098903
PMID: 29743171
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Secondary vascular risk reduction is critical to preventing recurrent stroke. We aimed to evaluate the effect of exercise interventions on vascular risk factors and recurrent ischaemic events after stroke or transient ischaemic attack (TIA). Intervention systematic review and meta-analysis. OVID MEDLINE, PubMed, The Cochrane Library, Web of Science, The National Institute for Health and Care Excellence, TRIP Database, CINAHL, PsycINFO, SCOPUS, UK Clinical Trials Gateway and the China National Knowledge Infrastructure were searched from 1966 to October 2017. Randomised controlled trials evaluating aerobic or resistance exercise interventions on vascular risk factors and recurrent ischaemic events among patients with stroke or TIA, compared with control. Twenty studies (n=1031) were included. Exercise interventions resulted in significant reductions in systolic blood pressure (SBP) -4.30 mm Hg (95% CI -6.77 to -1.83) and diastolic blood pressure -2.58 mm Hg (95% CI -4.7 to -0.46) compared with control. Reduction in SBP was most pronounced among studies initiating exercise within 6 months of stroke or TIA (-8.46 mm Hg, 95% CI -12.18 to -4.75 vs -2.33 mm Hg, 95% CI -3.94 to -0.72), and in those incorporating an educational component (-7.81 mm Hg, 95% CI -14.34 to -1.28 vs -2.78 mm Hg, 95% CI -4.33 to -1.23). Exercise was also associated with reductions in total cholesterol (-0.27 mmol/L, 95% CI -0.54 to 0.00), but not fasting glucose or body mass index. One trial reported reductions in secondary vascular events with exercise, but was insufficiently powered. Exercise interventions can result in clinically meaningful blood pressure reductions, particularly if initiated early and alongside education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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