Effect of Resistance Exercise on Ambulatory Blood Pressure: Systematic Review and Meta-Analysis

Abstract This systematic review/meta-analysis aimed to evaluate the effects of resistance exercise on ambulatory blood pressure (ABP). PubMed, Web of Science, Scielo, Embase, and Scopus databases were searched for crossover/controlled trials of resistance exercise in adults compared to a control group/condition from inception until May 2025. Mean differences with 95% confidence intervals were calculated (p<0.05 significant). Risk of bias was assessed by the Cochrane risk-of-bias tool for randomized trials. Twenty-six studies were included: 18 acute (immediate, short-term, including 351 participants) and 8 chronic (long-term, including 356 participants), with mostly unclear/high risk of bias. Acutely resistance exercises led to lower 24-hour diastolic blood pressure (BP) in subjects with chronic diseases (−1.15 mmHg;−2.08,−0.22; p=0.020), and lower daytime diastolic BP in healthy participants (−0.77 mmHg,−1.51,−0.03; p=0.040). Chronically resistance training lowered 24-hour systolic (−3.99 mmHg;−7.59,−0.39; p=0.030) and diastolic BP (−1.52 mmHg;−2.67,−0.37; p=0.009) and daytime systolic/diastolic BP in subjects with chronic diseases (Systolic:−5.53 mmHg;−8.83,−2.23; p=0.001; Diastolic:−1.86 mmHg;−3.11,−0.61; p=0.003). In conclusion, resistance exercise promotes modest reductions in ABP, especially among individuals with chronic diseases. The most consistent effects were observed for 24-hour and daytime systolic and diastolic BP. Acute reductions were smaller and limited to daytime diastolic BP.