Effectiveness of physical exercise on the cardiovascular system in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials

The primary purpose of this study is to structure the available evidence relating to physical exercise programs and their impact on patients' cardiovascular system during the convalescence for breast cancer. We searched six English databases and four Chinese databases from inception to May 19, 2021. Two reviewers independently screened literature, extracted data. They assessed the risk of bias according to the eligibility criteria, and the Cochrane Collaboration RevMan 5.3.0 version software and STATA 15.0 software were used for this meta-analysis. This study has been registered in the International Prospective Register of Systematic Reviews (CRD42021226319). In total, 3483 articles were screened and data from 11 randomized controlled trials (RCTs) involving 666 breast cancer patients were used in this meta-analysis. The results showed that exercise could decrease systolic blood pressure (SBP) (P = 0.006), diastolic blood pressure (DBP) (P = 0.0003), triglycerides (TG) levels (P < 0.00001), body mass index (BMI) (P = 0.009). Results also showed that exercise could significantly increase peak oxygen uptake (VO2peak) (P = 0.009), maximal oxygen consumption (VO2max) (P = 0.01), and High-density leptin cholesterol (HDL-C) levels (P < 0.0001). However, compared with the control group, there was no significant changes of mean arterial pressure (MAP), peak heart rate (HRpeak), and peak respiratory exchange ratio (PERpeak) (P > 0.05). Physical exercise could improve the cardiovascular system function associated with decreased the levels of SBP, DBP, TG, and increased the levels of VO2peak, VO2max, and HDL-C in breast cancer patients. These findings reveal that exercise may be a promising means for cardiovascular nursing. • Based on an evidence-based method to explore the physical exercise on the cardiovascular system. • Emphasizing the importance of physical exercise for breast cancer patients. • Providing a new perspective for improving the survival of breast cancer patients and a direction for future research. • Physical exercise is worth popularizing in clinical practice.