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Exercise blood pressure and cardiovascular disease risk: a systematic review and meta-analysis of cross-sectional studies


Moore, MN and Climie, RE and Otahal, P and Schultz, MG, Exercise blood pressure and cardiovascular disease risk: a systematic review and meta-analysis of cross-sectional studies, Journal of hypertension, 39, (12) pp. 2395-2402. ISSN 0263-6352 (2021) [Refereed Article]

Copyright Statement

2021 Wolters Kluwer Health, Inc.

DOI: doi:10.1097/HJH.0000000000002962


Background: A hypertensive response to exercise (HRE) is associated with cardiovascular disease and high blood pressure (BP). A poor cardiovascular risk factor profile may underlie these associations, although this has not been systematically elucidated. Via systematic review and meta-analysis, we aimed to assess the relationship between exercise BP and cardiovascular risk factors, and determine if cardiovascular risk is higher in those with an HRE vs. no-HRE across different study populations (including those with/without high BP at rest).

Methods: Three online databases were searched for cross-sectional studies reporting data on exercise BP, an HRE and cardiovascular risk factors (including arterial structure, lipid, metabolic, inflammatory and kidney function markers). Random-effects meta-analyses and meta-regression were used to calculate pooled correlations between exercise BP and each risk factor and pooled mean differences between those with/without an HRE.

Results: Thirty-eight studies (38 295 participants, aged 50 +- 3years; 78% male) were included. Exercise SBP was associated with arterial, lipid and kidney function risk markers (P < 0.05). Those with an HRE had greater aortic stiffness (+0.80 +- 0.35 m/s), total (+0.14 +- 0.03 mmol/l) and low-density lipoprotein (+0.12 +- 0.03 mmol/l) cholesterol, triglycerides (+0.24 +- 0.04 mmol/l), glucose (+0.15 +- 0.05 mmol/l), white blood cell count (+0.49 +- 0.16 mmol/l) and albumin-to-creatinine ratio (standardized mean difference: +0.97 +- 0.34), and lower flow-mediated dilation (-4.13 +- 1.02%) and high-density lipoprotein cholesterol (-0.04 +- 0.01 mmol/l) vs. those with no-HRE (P < 0.05 all). Results were broadly similar across study populations.

Conclusion: Exercise SBP is associated with multiple cardiovascular risk factors, which appear worse in those with an HRE vs. no-HRE. As results were similar across population groups, an HRE should be considered an important indicator of cardiovascular risk.

Item Details

Item Type:Refereed Article
Research Division:Health Sciences
Research Group:Sports science and exercise
Research Field:Exercise physiology
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Moore, MN (Mr Myles Moore)
UTAS Author:Climie, RE (Dr Rachel Climie)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Schultz, MG (Dr Martin Schultz)
ID Code:152449
Year Published:2021
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-08-19
Last Modified:2022-09-15

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