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Walking for hypertension.

The Cochrane database of systematic reviews
January 1, 1970
Ling-Ling Lee et al. (6 authors)
Journal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tSystematic ReviewHuman Study
Study Details

Study Goal

To determine the effect of walking as a physical activity intervention on blood pressure and heart rate.

Results Summary

Walking reduces systolic blood pressure (SBP) and diastolic blood pressure (DBP) across all age groups and both sexes, with moderate-certainty evidence for SBP and mixed certainty for DBP and heart rate. Adverse events were rare, with knee injury being the most reported issue.

Population

Participants aged 16 to 84 years, with approximately 1.5 times more females than males, from 22 countries.

Effective Dosage

Average walking time per week was 153 minutes, with majority at moderate intensity.

Duration

Average intervention length was 15 weeks.

Interactions

None mentioned

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
walking
decrease
systolic blood pressure
participants aged 16 years and over
MD -4.11 mmHg
reduces
#1
walking
decrease
systolic blood pressure
participants aged 40 years and under
MD -4.41 mmHg
reduces
#2
walking
decrease
systolic blood pressure
participants aged 41 to 60 years
MD -3.79 mmHg
reduces
#3
walking
decrease
systolic blood pressure
participants aged 60 years of over
MD -4.30 mmHg
reduces
#4
walking
decrease
systolic blood pressure
females
MD -5.65 mmHg
reduces
#5
walking
decrease
systolic blood pressure
males
MD -4.64 mmHg
reduces
#6
walking
decrease
diastolic blood pressure
participants aged 16 years and over
MD -1.79 mmHg
reduces
#7
walking
decrease
heart rate
participants aged 16 years and over
MD -2.76 beats per minute
reduces
#8
walking
decrease
diastolic blood pressure
participants aged 40 years and under
MD -3.01 mmHg
reduces
#9
walking
decrease
diastolic blood pressure
participants aged 41 to 60 years
MD -1.74 mmHg
reduces
#10
walking
decrease
diastolic blood pressure
participants aged 60 years and over
MD -1.33 mmHg
reduces
#11
walking
decrease
diastolic blood pressure
males
MD -2.54 mmHg
reduces
#12
walking
decrease
diastolic blood pressure
females
MD -2.69 mmHg
reduces
#13
Abstract

BACKGROUND: Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low-cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings. OBJECTIVES: To determine the effect of walking as a physical activity intervention on blood pressure and heart rate. SEARCH METHODS: We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA: Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non-intervention control on blood pressure and heart rate were included. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings. MAIN RESULTS: A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias. Primary outcome We found moderate-certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n = 5060). We found moderate-certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD -4.41 mmHg, 95% CI -6.17 to -2.65; 14 studies, n = 491), and low-certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD -3.79 mmHg, 95% CI -5.64 to -1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD -4.30 mmHg, 95% CI -6.17 to -2.44, 24 studies, n = 2610). We also found low certainty-evidence suggesting that walking reduces SBP in both females (MD -5.65 mmHg, 95% CI -7.89 to -3.41; 22 studies, n = 1149) and males (MD -4.64 mmHg, 95% CI -8.69 to -0.59; 6 studies, n = 203). Secondary outcomes We found low-certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n = 4711) and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n = 1747). We found moderate-certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD -3.01 mmHg, 95% CI -4.44 to -1.58; 14 studies, n = 491) and low-certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD -1.74 mmHg, 95% CI -2.95 to -0.52; 32 studies, n = 1730) and those aged 60 years and over (MD -1.33 mmHg, 95% CI -2.40 to -0.26; 23 studies, n = 2490). We found moderate-certainty evidence that suggests walking reduces DBP for males (MD -2.54 mmHg, 95% CI -4.84 to -0.24; 6 studies, n = 203) and low-certainty evidence that walking reduces DBP for females (MD -2.69 mmHg, 95% CI -4.16 to -1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times. AUTHORS' CONCLUSIONS: Moderate-certainty evidence suggests that walking probably reduces SBP. Moderate- or low-certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low-certainty evidence suggests that walking may reduce DBP and heart rate. Moderate- and low-certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.

Medical Subject Headings (MeSH)
AdolescentAdultAge FactorsAgedAged, 80 and overBiasBlood PressureDiastoleFemaleHeart RateHumansHypertensionKnee InjuriesMaleMiddle AgedRandomized Controlled Trials as TopicSystoleTime FactorsWalkingYoung Adult
Study Links
Quality Scores
Safety85
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations38
Citations/Year9.5
Relative Citation Ratio3.14
NIH Percentile85.9%
Research Impact Scores
APT Score0.95
Weight Score1.82
Normalized Score0.80
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