The effect of exercise training on heart rate variability in patients with hypertension: A systematic review and meta-analysis

ABSTRACT

We aimed to assess the effect of exercise training on heart rate variability (HRV) in hypertensive patients and to provide practical recommendations. We systematically searched seven databases for randomized controlled trials (RCTs) comparing the efficacy of exercise interventions vs. non-exercise control for HRV in adults with hypertension. HRV parameters, blood pressure (BP), and heart rate (HR) from the experimental and control groups were extracted to carry out meta-analysis. To explore the heterogeneity, we performed sensitivity analysis, sub-analysis, and meta-regression. Twelve RCTs were included, and the main results demonstrated exercise produced improvement in root mean square of successive RR-intervals differences (RMSSD) and high frequency (HF), and reductions in LF/HF, resting systolic blood pressure (SBP), and HR. The sub-analysis and meta-regression showed that AE improved more HRV indices and was effective in reducing BP compared with RE. Follow-up duration was also an important factor. Data suggests exercise training has ameliorating effects on HRV parameters, resting SBP, and HR in hypertensive patients, showing enhanced autonomic nervous system function and vagal activity. This effect may be better realized with exercise interventions of 4 weeks or more. Considering our results and the hypertension practice guidelines, we tend to recommend patients choose supervised AE.

GRAPHICAL ABSTRACT

KEYWORDS:

• Exercise
• heart rate variability
• hypertension
• autonomic nervous system

Acknowledgments

The author would like to thank Xiaoke Chen and Laikang Yu for guiding and advising on conducting meta-regressions and related details.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Geolocation information

The Geolocation information of this study was the Department of Exercise Physiology, Beijing Sport University, No. 48, Xinxi Road, Haidian District, Beijing, P.R. China.

Supplementary material

Supplemental data for this article can be accessed online https://doi.org/10.1080/02640414.2024.2388984

Additional information

Funding

This study was supported by grants from the Chinese National key research and Development Program, Project No. [2022YFC3600201] and the Chinese Universities Scientific Fund [2024JCYJ001, 2024YJSY002].