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Can postexercise hypotension also be observed in African and Asian populations: a systematic review and meta-analysis of randomized controlled trials

Journal of Human Hypertension volume 37, pages 1076–1085 (2023)Cite this article

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Abstract

Worldwide, raised blood pressure (BP) or hypertension is the global leading risk factor for the development of cardiovascular diseases and all-cause mortality, with the highest prevalence found in Asian and African origin populations. Post-exercise hypotension (PEH), defined as a sustained reduction in BP after a single bout of exercise is an important physiological phenomenon in BP management. However, little is known about the hypotensive effect of a single bout of exercise in non-Caucasian populations. We systematically summarized the acute effects of a single bout of aerobic exercise on BP in a population of African or Asian origin. We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations with optimal BP, high normal BP or hypertension published in a peer reviewed journal up to August 2021. A subsequent meta-analysis was performed using random-effect models fitted to estimate effect sizes. We identified 10 aerobic exercise trials performed in individuals of Asian origin (n = 136; mean age: 29.51 (21.2–69) years: 78% male; baseline systolic BP/diastolic BP: 118.9 ± 9.64/68.9 ± 2.69 mmHg) and 11 aerobic exercise trials involving individuals of African origin (n = 157; mean age: 41.05 (29.9–49) years; 59% male; baseline systolic BP/diastolic BP: 134.5 ± 8.65 mmHg/82.2 ± 3.24 mmHg). Non-significant reductions in office systolic BP and diastolic BP at 30 min post exercise (−2.25 [−6.38, 1.88] mmHg, p = 0.28/−1.02 [−2.51, 0.47] mmHg, p = 0.18) and 60 min post exercise (−2.80 [−7.90, 2.28], p = 0.27/−1.95, [−5.66, 1.75], p = 0.3) were observed compared to the control intervention. No statistically significant differences were found between both ethnic groups (p > 0.05). Ambulatory BP was reported only in a few African groups. No effect was found on 24h-systolic BP post exercise, but 24h-diastolic BP was statistically significantly reduced (−1.89 [−3.47, −0.31] mmHg, p < 0.01) after a bout of aerobic exercise compared to the control intervention. The available evidence is insufficient to recommend a single session of aerobic exercise as an efficient tool to lower BP in African and Asian populations. Though, the paucity of data in non-Caucasian populations underscores the need for additional efforts to establish the efficacy of single bouts of exercise, including isometric and dynamic resistance exercise, as a potential non-pharmacological adjunct to help lowering BP in the daily life of descendants of Asian or African origin.

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Data will be made available on reasonable request to veronique.cornelissen@kuleuven.be.

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Funding

MB received a research grant for short stay funded by the FWO (Application number: K21523N). KG is supported by São Paulo Research Foundation (FAPESP, Application number: 2019/18039-7).

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Authors and Affiliations

  1. Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname

    M. Bersaoui, A. Bisai & S. M. Baldew

  2. Department of Rehabilitation Sciences, Cardiovascular Exercise Physiology Unit, KU Leuven, Leuven, Belgium

    M. Bersaoui & V. A. Cornelissen

  3. Department of Physiology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname

    J. Toelsie

  4. Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil

    K. Goessler

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Contributions

VC and MB contributed to the conception of this systematic review. MB and AB performed the data collection. MB performed the statistical analysis and drafted the manuscript. MB, AB, VC, SB, JT and KG contributed to interpretation of the results and critically reviewed the manuscript. VC supervised the data collection and statistical analysis. All authors have read and approved the final version of the manuscript and agree with the order of presentation of the authors.

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Bersaoui, M., Bisai, A., Baldew, S.M. et al. Can postexercise hypotension also be observed in African and Asian populations: a systematic review and meta-analysis of randomized controlled trials. J Hum Hypertens 37, 1076–1085 (2023). https://doi.org/10.1038/s41371-023-00844-8

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