Evidence map›Paper›PMID 34192008›Full record

ReviewBMJ open sport & exercise medicine2021

Do the combined blood pressure effects of exercise and antihypertensive medications add up to the sum of their parts? A systematic meta-review.

Linda S Pescatello, Yin Wu, Simiao Gao, Jill Livingston, Bonny Bloodgood Sheppard, Ming-Hui Chen

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ open sport & exercise medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Guideline
  2. Exercise for counteracting weight recurrence after bariatric surgery: a systematic review and meta-analysis of randomized controlled trials.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2023
    Pooled it
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  16. Physical Activity and Hypertension.Reviews in cardiovascular medicine · 2022
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Linda S PescatelloDepartment of Kinesiology, University of Connecticut, Storrs, Connecticut, USA.ORCID 0000-0002-5841-798X
Yin WuDepartment of Kinesiology, University of Connecticut, Storrs, Connecticut, USA.ORCID 0000-0001-8647-4706
Simiao GaoDepartment of Statistics, University of Connecticut, Storrs, Connecticut, USA.
Jill LivingstonWesleyan University, Middletown, Connecticut, USA.
Bonny Bloodgood SheppardICF Next, Fairfax, Virginia, USA.
Ming-Hui ChenDepartment of Statistics, University of Connecticut, Storrs, Connecticut, USA.ORCID 0000-0003-1935-2447
University of Connecticut · USICF International (United States) · USWesleyan University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the blood pressure (BP) effects of exercise alone (EXalone), medication alone (MEDSalone) and combined (EX+MEDScombined) among adults with hypertension. DATA SOURCES: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Cochrane Library. ELIGIBILITY CRITERIA: Randomised controlled trails (RCTs) or meta-analyses (MAs) of controlled trials that: (1) involved healthy adults>18 year with hypertension; (2) investigated exercise and BP; (3) reported preintervention and postintervention BP and (4) were published in English. RCTs had an EX+MEDScombined arm; and an EXalone arm and/or an MEDSalone arm; and MAs performed moderator analyses.

designA systematic network MA and meta-review with the evidence graded using the Physical Activity Guidelines for Americans Advisory Committee system. OUTCOME: The BP response for EXalone, MEDSalone and EX+MEDScombined and compared with each other.

resultsTwelve RCTs qualified with 342 subjects (60% women) who were mostly physically inactive, middle-aged to older adults. There were 13 qualifying MAs with 28 468 participants (~50% women) who were mostly Caucasian or Asian. Most RCTs were aerobic (83.3%), while the MAs involved traditional (46%) and alternative (54%) exercise types. Strong evidence demonstrates EXalone, MEDSalone and EX+MEDScombined reduce BP and EX+MEDScombined elicit BP reductions less than the sum of their parts. Strong evidence indicates EX+MEDScombined potentiate the BP effects of MEDSalone. Although the evidence is stronger for alternative than traditional types of exercise, EXaloneelicits greater BP reductions than MEDSalone.

conclusionsThe combined BP effects of exercise and medications are not additive or synergistic, but when combined they bolster the antihypertensive effects of MEDSalone. PROSPERO REGISTRATION NUMBER: The protocol is registered at PROSPERO CRD42020181754.

Indexed as

cardiovascularexerciseheart diseasepharmacologyphysical activity

Identifiers

PMID34192008
PMCPMC7818845
OpenAlexW3125663183

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.