Alvarez-Barbosa, Francisco , RAMOS MUNELL, JAVIER, del Pozo-Cruz, Jesus , del Pozo Cruz, Borja , Ceballos-Sanchez, Jose Luis , Gallardo-Gomez, Daniel
No
Rev Endocr Metab Disord
Review
Científica
19/11/2025
001616707900001
People with type 2 diabetes have higher rates of hypertension compared to the general population, Current guidelines do not consider the baseline blood pressure for activity prescription. This study aimed to evaluate and compare effects of different physical activity modalities on blood pressure in individuals with type 2 diabetes mellitus considering baseline blood pressure levels and exploring the dose-response relationship. A systematic search was performed in CINAHL, EMBASE, MEDLINE, Scopus, SportDiscus and WOS databases to June 2025. A dose-response network meta-analysis of 71 trials (3,970 participants) was conducted. Studies included individuals with type 2 diabetes who underwent any physical activity intervention with reported blood pressure outcomes. Meta-regressions included baseline blood pressure as a covariate. Aerobic activity significantly reduced systolic blood pressure (SBP) in stage 1 (-5.37 mmHg) and stage 2 hypertension (-8.32 mmHg). Mind-body activities showed noConsent to Participate effects, particularly in more severe hypertension (-13.35 mmHg). Resistance training was most effective for elevated SBP. Both aerobic and mind-body exercises improved diastolic blood pressure (DBP). A significant overall dose-response association was found, but it was not maintained when analyses were stratified by exercise modality, indicating that the observed benefits likely reflect overall physical activity exposure rather than modality-specific effects. Resistance training may be most effective for elevated SBP, aerobic activity for stage 1-2 systolic hypertension, and mind-body therapies for more severe diastolic hypertension. Optimal effects were achieved at approximately 826 and 994 METs-min/week for SBP and DBP, respectively.
Systolic blood pressure; Diastolic blood pressure; Exercise; Meta-analysis; Type 2 diabetes mellitus