Introduction:Hypertension is one of the leading causes of cardiovascular diseases worldwide, yet its control remains inadequate. Exercise is recognized as an effective non-pharmacological intervention for reducing blood pressure; however, the impact of exercise on blood pressure may vary depending on underlying pathophysiological variables, exercise type, and geographical location. This study aims to systematically review and meta-analyze the effects of these variables on blood pressure reduction.

Methodology:In this systematic review, data from over 435 randomized controlled trials published up to August 1, 2023, were extracted from Ovid MEDLINE and the Cochrane Library and analyzed. A random-effects model was used to estimate the effect size of exercise on systolic blood pressure across different patient groups considering exercise type and geographic region.

Results:The findings indicated that exercise significantly reduced systolic blood pressure in healthy individuals and patients with lifestyle-related diseases, but no significant reduction was observed in patients with cardiovascular diseases. All types of exercise were effective in healthy groups and those with lifestyle-related conditions. Geographically, no reduction in blood pressure was observed in Oceania, whereas in Asia, exercise was able to reduce blood pressure in patients with cardiovascular diseases.

Conclusion: Exercise is confirmed as an effective method for lowering blood pressure in healthy populations and individuals with lifestyle-related diseases; however, its impact in cardiovascular patients is limited and influenced by geographic region. Therefore, when prescribing exercise for blood pressure control, the patient’s pathophysiological status and geographical context should be considered to achieve optimal outcomes.