Effects of recreational sports and combined training on blood pressure and glycated hemoglobin in middle-aged and older adults: A systematic review with meta-analysis

Recreational beach tennis training reduces ambulatory blood pressure in adults with hypertension: a randomized clinical trial

OBJECTIVE

To determine the effect of 12 weeks of beach tennis training on 24-h ambulatory blood pressure in adults with essential hypertension.

METHODS

This was a randomized, single-blinded, two-arm, parallel superiority trial. Forty-two participants aged 35-65 years with a previous diagnosis of hypertension were randomized into 12 weeks of beach tennis training group (two sessions per week lasting 45-60 min) or a nonexercising control group. Ambulatory 24 h (primary outcome) and office blood pressure, heart rate at rest, cardiorespiratory fitness, and muscle strength were assessed at baseline and after the intervention period. Generalized estimating equation analyses were employed to examine the main effects of the interventions.

RESULTS

In the beach tennis group, night-time systolic (-9 mmHg, P  = 0.023), diastolic (-4 mmHg, P  = 0.026), and mean arterial pressure (-7 mmHg, P  = 0.023) decreased after 12 weeks of training. The office SBP/DBP (-6 mmHg, P  = 0.016/-6 mmHg, P  = 0.001) also decreased in the beach tennis group. Heart rate at rest decreased in the beach tennis group (-4 bpm, P  = 0.012) but increased in the control group (6 bpm, P  = 0.005). The lower and upper limb muscle strength increased in the beach tennis group after training. However, no such changes were observed in the control group.

CONCLUSION

A 12-week recreational beach tennis training significantly reduced office and ambulatory BP among untrained adults with essential hypertension. Additionally, participation in this sport has led to improvements in physical fitness and overall cardiovascular risk profiles.This clinical trial was registered at Clinicaltrials.gov (NCT03909321).

Effects of jazz dance and concurrent training on psychological variables in menopausal women: A randomized controlled trial

PURPOSE

To analyze the effect of two 16-week interventions with jazz dance and concurrent training compared to a control group on anxiety, depression, stress, mood, and the perspective of aging in menopausal women, after 1-month, post-intervention, and at the 6-month follow-up.

METHODS

70 post-menopausal women (53.19 ± 3.39 years) randomized into 3 groups:intervention group with Jazz Dance (JD); intervention group with Concurrent Training (CT), and Control Group (CG). Both interventions lasted 16 weeks, with 60-min classes, JD with a frequency of two weekly classes, and CT three times a week. The intensity of the JD was progressive and according to the frequency of beats per minute of the songs. In CT, the aerobic an initial intensity of 60% of HRmax, reaching 90%, and resistance the volume of sets and loads increased progressively throughout the intervention. Questionnaires related to symptoms of anxiety and depression (Hospital Anxiety and Depression Scale); stress (Perceived Stress Scale); mood (Brunel Mood Scale); and aging perspective (Sheppard Inventory) were applied. Intention-to-treat (ITT) and protocol adherence analysis were performed.

RESULTS

In the protocol analysis, the JD showed improvements in anxiety and depressive symptoms after 1-month, which remained at the follow-up. The TC presented reduced anxiety and depressive symptoms after 16 weeks, which also remained at the follow-up. Considering stress, the CT showed improvements at all times and the JD post-intervention. As for mood, the CT presented reduced anger, mental confusion, and fatigue only after 1-month, and both exercise groups presented increased vigor at all times.

CONCLUSION

Both interventions were beneficial, however dance showed immediate results for anxiety and depression, and concurrent training for stress. Considering mood, concurrent training was more effective for anger, mental confusion, and fatigue, while both interventions were effective for vigor.

REGISTRATION

Brazilian Clinical Trials Registry (REBEC) RBR - 87ndrv.

The mediation and interaction of the obesity index between moderate-vigorous recreational physical activity and hypertension

Previous studies showed that physical activity (PA) is concerned with hypertension (HTN). However, the mediation and interaction role of the obesity index: body mass index (BMI), waist-hip ratio (WHR), body fat rate (BFR) and visceral fat index (VFI) between PA and HTN has never been studied. Therefore, the purpose of this study was to assess the mediation and interaction of the obesity index between moderate-vigorous recreational physical activity (MVRPA) and HTN. We conducted a cross-sectional study of 4710 individuals aged 41 or older in Torch Development Zone, Zhongshan City. The mediation and interaction of the obesity index were evaluated by a four-way decomposition. 48.07% of participants had HTN among these groups. In the adjusted linear regression model, MVRPA was significantly correlated with WHR (β±SE = -0.005±0.002; P<0.05). Compared to sufficient MVRPA (odds ratio (OR) = 1.35), 95% (confidence interval (CI) = 1.17-1.56), insufficient MVRPA increased the risk of developing HTN. Furthermore, there were associations between BMI, WHR, BFR, VFI and HTN where the adjusted ORs and 95% CIs were 1.11 (1.09-1.13), 6.23 (2.61-14.90), 1.04 (1.03-1.06), 1.07 (1.06-1.09), respectively. The mediation analyses suggested that the impact of MVRPA on HTN risk may partly be explained by changes in obesity index, with a pure indirect mediation of WHR between MVRPA and HTN (P<0.05). Therefore, weight control, especially reducing abdominal obesity and maintaining adequate MVRPA, may lead to more proper control of HTN.

Statistical heterogeneity in meta-analysis of hypertension and exercise training: A meta-review

We aim to evaluate the prevalence of reporting and the extent of statistical heterogeneity of systematic reviews with meta-analyses (SRMAs) of exercise training for hypertension and to provide practical recommendations for dealing with statistical heterogeneity. We systematically searched on four databases (from 2002 to September of 2023) for SRMAs comparing exercise interventions vs. a non-exercise control on blood pressure (BP) control in adults with hypertension. Fifty-nine SRMAs, with a median of 14 studies, were analysed. Cochran's Q (41%), I2 (24%), forest plots (44%), and particularly τ2 (54%) and prediction intervals (96.6%) frequently were not reported for the hypertension subgroup. The recalculated prediction intervals were discrepant (i.e., crossed the null effect) of significant 95% confidence intervals of most meta-analyses (systolic BP: 65%; diastolic BP: 92%). This suggests substantial heterogeneity across studies, which was often not acknowledged by authors' conclusions (78%). Consequently, downgrading the certainty of the available evidence may be justified alone due to heterogeneity across studies. Finally, we illustrate areas for improving I2 interpretation and provide practical recommendations on how to address statistical heterogeneity across all stages of a SRMA.

Exercise characteristics and blood pressure reduction after combined aerobic and resistance training: a systematic review with meta-analysis and meta-regression

OBJECTIVE

The purpose of this systematic review with meta-analysis was to determine the efficacy of combined aerobic and strength training in adults with hypertension and the influence of exercise training characteristics on blood pressure (BP) reduction.

METHODS

Randomized clinical trials of interventions involving combined aerobic and strength training versus nonexercise control groups (Control) in adults with hypertension were included. The literature search was conducted on PubMed, Cochrane Central, EMBASE, Scopus, and LILACS until December 2021. A random effects meta-analysis was performed using the mean difference in BP changes from baseline, comparing combined aerobic and strength training vs. Control as the effective measure. A multivariate meta-regression analysis was also performed to evaluate the relationship between exercise training characteristics and magnitudes of BP reductions.

RESULTS

Thirty-seven studies with 41 exercise interventions (1942 participants) were analyzed. The pooled mean differences with a 95% confidence interval (95% CI) showed significant reductions in SBP (-6.4 mmHg; 95% CI, -9.1 to -3.6) and DBP (-3.7 mmHg; 95% CI, -4.9 to -2.4). Meta-regression analysis revealed that greater exercise intensity and a greater number of sets in resistance training were associated with greater reductions in SBP. Greater exercise intensity was also associated with greater decreases in DBP.

CONCLUSION

Combined aerobic and resistance training is an effective intervention in reducing both SBP and DBP in adults with hypertension, with greater hypotensive effects expected with higher intensity and more volume.