Resistance training and blood pressure: Insights from a meta-analysis of the aging population

Abstract

Background

Hypertension is a prevalent cardiovascular risk factor in older adults, contributing to morbidity and mortality worldwide. While aerobic exercise is well-established for blood pressure (BP) management, the role of resistance training (RT) in aging populations remains less clear, with inconsistent findings across studies.

Objective

To evaluate the effect of RT on BP in adults aged 60 and older and explore moderators such as intervention duration, gender, and session frequency.

Method

Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar for randomized controlled trials (RCTs) of RT (≥4 weeks) in older adults (mean age ≥60 years), published until February 2025. Data on systolic, diastolic, and mean BP were pooled using random-effects models, with subgroup and meta-regression analyses to assess heterogeneity sources.

Results

Fifty-one RCTs (n = 2025) demonstrated that RT significantly reduced systolic BP (MD = -6.11 mmHg), diastolic BP (MD = -2.53 mmHg), and mean BP (MD = -4.10 mmHg; all p < 0.001). Subgroup analysis revealed larger systolic (females: -7.95 mmHg; males: -6.02 mmHg, NS) and diastolic BP reductions (females: -4.24 mmHg; males: -3.39 mmHg, NS), with mean BP reduced significantly in both sexes (females: -4.02 mmHg; males: -7.08 mmHg). Short-term (≤12 weeks) and higher frequency interventions enhanced BP reductions. Heterogeneity was high but sensitivity analyses confirmed robustness.

Conclusion

RT effectively lowers BP in older adults, supporting its inclusion in hypertension management strategies. Short-term, frequent RT protocols may optimize outcomes, particularly for females. Further research is needed to explore long-term effects and underlying mechanisms.