Increasing Physical Activity for the Treatment of Hypertension: A Systematic Review and Meta-Analysis
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REVIEW ARTICLE
Increasing Physical Activity for the Treatment of Hypertension: A Systematic Review and Meta-Analysis Thomas Semlitsch • Klaus Jeitler • Lars G. Hemkens • Karl Horvath • Eva Nagele • Christoph Schuermann • Nicole Pignitter • Kirsten H. Herrmann Siw Waffenschmidt • Andrea Siebenhofer
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Springer International Publishing Switzerland 2013
Abstract Background Low physical activit\y has been identified as a major risk factor for cardiovascular disease. Medical societies therefore recommend increased physical activity be part of any antihypertensive therapy. Objective Focusing on patient-relevant outcomes such as mortality and cardiovascular events, this review was conducted to assess the long-term effects of interventions aiming at increasing physical activity in comparison with no such interventions on adult patients with essential hypertension. Data sources We searched for high-quality systematic reviews in MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (Cochrane Reviews), Database of Abstracts of Reviews of Effects (Other Reviews) and Health Technology Assessment Database (Technology Electronic supplementary material The online version of this article (doi:10.1007/s40279-013-0065-6) contains supplementary material, which is available to authorized users. T. Semlitsch (&) K. Jeitler K. Horvath E. Nagele N. Pignitter Department of Internal Medicine, Evidence Based Medicine Review Center, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria e-mail: [email protected] T. Semlitsch HEALTH-Institute for Biomedicine and Health Sciences, Joanneum Research, Graz, Austria K. Jeitler Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria L. G. Hemkens Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
Assessments) published between 1997 and February 2009 and for randomized controlled trials (RCTs) in MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (Clinical Trials) published before September 2012. Additional studies were identified by hand searching reference lists of reviews. Study selection RCTs with at least 24 weeks’ follow-up that evaluated the effect of increased physical activity on the blood pressure of adults with essential hypertension were included in our review. Primary outcomes were allcause mortality, cardiovascular morbidity and mortality, end-stage renal disease, quality of life and adverse events. Study appraisal and synthesis methods When appropriate, we used random effects meta-analyses to determine mean difference with 95 % confidence intervals for each endpoint. All data were analysed using the Review Manager software version 5.0.24 from the Cochrane Collaboration. Results None of the included nine trials, covering 891 patients with hypertension, provided sufficient data on K. Horvath Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria C. Schuerman
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