Exercise interventions lower BP in patients after stroke

  • Wang C & al.
  • Br J Sports Med
  • 9 May 2018

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway

  • Exercise interventions after stroke or transient ischaemic attack (TIA) are safe and result in clinically meaningful reductions in systolic BP (SBP) and diastolic BP (DBP).

Why this matters

  • Previous studies have shown that exercise after stroke improves walking speed and balance; however, no clarity exists regarding its effect on secondary vascular risk factors.

Study design

  • 20 studies involving 1031 patients met eligibility criteria after a search on PubMed, MEDLINE, CINAHL, PsycINFO, SCOPUS, UK Clinical Trials Gateway, The Cochrane Library and other electronic databases from 1966 to October 2017.
  • Funding: None disclosed.

Key results

  • Compared with the control group, a significant reduction in SBP (−4.30 mm Hg; 95% CI, −6.77 to −1.83) and DBP (−3.12 mm Hg; 95% CI, −4.89 to −1.34) was seen with exercise intervention.
  • Exercise interventions initiated within 6 months of stroke or TIA appeared to have a greater effect on SBP vs those initiated after 6 months (−8.46 mm Hg [95% CI, −12.18 to −4.75] vs −2.33 mm Hg [95% CI, −3.94 to −0.72]).
  • Exercise interventions incorporating an educational component appeared to have a larger effect on SBP vs those with no education component (−7.81 mm Hg [95% CI, −14.34 to −1.28] vs −2.78 mm Hg [95% CI, −4.33 to −1.23]).
  • Pooled analysis of 9 studies showed significant reductions in total cholesterol with exercise (−0.27 mmol/L; P=.05).
  • No effect was seen on fasting glucose and BMI.

Limitations

  • Limited number of studies.
  • Publication bias.