Skip to main content

Running to Lower Resting Blood Pressure: A Systematic Review and Meta-analysis



According to previous epidemiological studies, there are pros and cons for the relationship between running regularly and changes in resting blood pressure (RBP), and the changes may depend on the form of exercise.


The aims of the current systematic review were to summarize the effects of running regularly on RBP and to investigate the most efficacious form of running in reducing RBP for this purpose.


The inclusion criteria were: randomized controlled trials, involving healthy adults or adults with hypertension, the exercise group only performed regular running and the control group did not exercise, and the study reported the mean resting systolic blood pressure (RSBP) and/or diastolic blood pressure (RDBP). The mean difference (MD) in RBP in each trial was defined as follows: (mean value at post-intervention in the exercise group − mean value at baseline in the exercise group) − (mean value at post-intervention in the control group − mean value at baseline in the control group) and was calculated. The weighted MD (WMD) was defined as the synthesis of all MD. A linear meta-regression analysis, exercise intensity [the percentage of maximum heart rate] (%) and total exercise time throughout the intervention (hours) were selected as explanatory variables and the MD in RBP served as the objective variable.


Twenty-two trials (736 subjects) were analyzed. When trials were limited to those involving healthy subjects, the WMD in RBP decreased significantly [RSBP: − 4.2 mmHg (95% confidence intervals (95% CI) − 5.9 to − 2.4); RDBP: − 2.7 mmHg (95% CI − 4.2 to − 1.1)] and did not contain significant heterogeneity (RSBP: P = 0.67, I2 = 0.0%; DBP: P = 0.38, I2 = 7.2%). When trials were limited to those involving subjects with hypertension, the WMD in RBP decreased significantly [RSBP: − 5.6 mmHg (95% CI − 9.1 to − 2.1); RDBP: − 5.2 mmHg (95% CI − 9.0 to − 1.4)] but contained significant heterogeneity (RSBP: P = 0.01, I2 = 62.2%; DBP: P < 0.01, I2 = 87.7) and a meta-regression analysis showed that the percentage of maximum heart rate was significantly associated with the WMD in RSBP [slope: 0.56 (95% CI 0.21 to 0.92), intercept: − 48.76 (95% CI − 76.30 to − 21.22), R2 = 0.88] and RDBP [slope: 0.45 (95% CI 0.01 to 0.87), intercept: − 38.06 (95% CI − 72.30 to − 4.08), R2 = 0.41]. When trials were limited to those involving subjects with hypertension and a mean age ≥ 40 years, a meta-regression analysis showed that total exercise time throughout the intervention was significantly associated with the WMD in RDBP [slope: 0.82 (95% CI 0.54 to 1.09), intercept: − 22.90 (95% CI − 29.04 to − 16.77), R2 = 0.99].


Running regularly decreases RBP, but the changes in subjects with hypertension may differ depending on exercise intensity or total exercise time. Therefore, running regularly at moderate intensity and at a restrained volume is recommended to lower RBP in subjects with hypertension.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Data Availability Statement

All data are available in submitted manuscript or as electronic supplementary material.


  1. 1.

    Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011–2012. NCHS Data Brief. 2013;133:1–8.

    Google Scholar 

  2. 2.

    Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.

    Google Scholar 

  3. 3.

    Kokubo Y. Prevention of hypertension and cardiovascular diseases: a comparison of lifestyle factors in Westerners and East Asians. Hypertension. 2014;63:655–60.

    CAS  PubMed  Google Scholar 

  4. 4.

    Carey RM, Muntner P, Bosworth HB, Whelton PK. Prevention and control of hypertension: JACC Health Promotion Series. J Am Coll Cardiol. 2018;72:1278–93.

    PubMed  PubMed Central  Google Scholar 

  5. 5.

    Dickinson HO, Mason JM, Nicolson DJ, Campbell F, Beyer FR, et al. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006;24:215–33.

    CAS  PubMed  Google Scholar 

  6. 6.

    Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2001;38:1112–7.

    CAS  PubMed  Google Scholar 

  7. 7.

    Graudal NA, Hubeck-Graudal T, Jürgens G. Effects of low-sodium diet vs. high-sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (cochrane review). Am J Hypertens. 2012;25:1–15.

    CAS  PubMed  Google Scholar 

  8. 8.

    Murtagh EM, Nichols L, Mohammed MA, Holder R, Nevill AM, Murphy MH. The effect of walking on risk factors for cardiovascular disease: an updated systematic review and meta-analysis of randomised control trials. Prev Med. 2015;72:34–43.

    PubMed  Google Scholar 

  9. 9.

    Igarashi Y, Akazawa N, Maeda S. The required step count for a reduction in blood pressure: a systematic review and meta-analysis. J Hum Hypertens. 2018;32:814–24.

    PubMed  Google Scholar 

  10. 10.

    Oja P, Kelly P, Murtagh EM, Murphy MH, Foster C, Titze S. Effects of frequency, intensity, duration and volume of walking interventions on CVD risk factors: a systematic review and meta-regression analysis of randomised controlled trials among inactive healthy adults. Br J Sports Med. 2018;52:769–75.

    PubMed  Google Scholar 

  11. 11.

    Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–8.

    CAS  PubMed  Google Scholar 

  12. 12.

    Igarashi Y, Nogami Y. The effect of regular aquatic exercise on blood pressure: a meta-analysis of randomized controlled trials. Eur J Prev Cardiol. 2018;25:190–9.

    PubMed  Google Scholar 

  13. 13.

    Igarashi Y, Akazawa N, Maeda S. Regular aerobic exercise and blood pressure in East Asians: a meta-analysis of randomized controlled trials. Clin Exp Hypertens. 2018;40:378–89.

    PubMed  Google Scholar 

  14. 14.

    Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493–503.

    PubMed  Google Scholar 

  15. 15.

    Manfredini F, Malagoni AM, Mandini S, Boari B, Felisatti M, et al. Sport therapy for hypertension: why, how, and how much? Angiology. 2009;60:207–16.

    PubMed  Google Scholar 

  16. 16.

    Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, et al. 2011 Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43:1575–81.

    PubMed  Google Scholar 

  17. 17.

    Stamatakis E, Chaudhury M. Temporal trends in adults’ sports participation patterns in England between 1997 and 2006: the Health Survey for England. Br J Sports Med. 2008;42:901–8.

    CAS  PubMed  Google Scholar 

  18. 18.

    Juraschek SP, Blaha MJ, Whelton SP, Blumenthal R, Jones SR, et al. Physical fitness and hypertension in a population at risk for cardiovascular disease: the Henry Ford ExercIse Testing (FIT) Project. J Am Heart Assoc. 2014.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Williams PT, Thompson PD. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Arterioscler Thromb Vasc Biol. 2013;33:1085–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Pressler A, Suchy C, Friedrichs T, Dallinger S, Grabs V, et al. Running multiple marathons is not a risk factor for premature subclinical vascular impairment. Eur J Prev Cardiol. 2017;24:1328–35.

    PubMed  Google Scholar 

  21. 21.

    Morrison BN, McKinney J, Isserow S, Lithwick D, Taunton J, et al. Assessment of cardiovascular risk and preparticipation screening protocols in masters athletes: the Master Athlete Screening Study (MASS): a cross-sectional study. BMJ Open Sport Exerc Med. 2018.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Schnohr P, O’Keefe JH, Marott JL, Lange P, Jensen GB. Dose of jogging and long-term mortality: the Copenhagen City Heart Study. J Am Coll Cardiol. 2015;65:411–9.

    PubMed  Google Scholar 

  23. 23.

    Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64:472–81.

    PubMed  PubMed Central  Google Scholar 

  24. 24.

    Kikuchi H, Inoue S, Lee IM, Odagiri Y, Sawada N, et al. Impact of moderate-intensity and vigorous-intensity physical activity on mortality. Med Sci Sports Exerc. 2018;50:715–21.

    PubMed  Google Scholar 

  25. 25.

    Lavie CJ, Lee DC, Sui X, Arena R, O’Keefe JH, et al. Effects of running on chronic diseases and cardiovascular and all-cause mortality. Mayo Clin Proc. 2015;90:1541–52.

    PubMed  Google Scholar 

  26. 26.

    Lee DC, Brellenthin AG, Thompson PD, Sui X, Lee IM, Lavie CJ. Running as a key lifestyle medicine for longevity. Prog Cardiovasc Dis. 2017;60:45–55.

    PubMed  Google Scholar 

  27. 27.

    Hespanhol Junior LC, Pillay JD, van Mechelen W, Verhagen E. Meta-analyses of the effects of habitual running on indices of health in physically inactive adults. Sports Med. 2015;45:1455–68.

    PubMed  PubMed Central  Google Scholar 

  28. 28.

    Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647.

    Google Scholar 

  29. 29.

    University of York, Centre for reviews and dissemination. PROSPERO: international prospective register of systematic reviews. 2011. Accessed 25 Jan 2019.

  30. 30.

    Cochrane Skin Group. Data collection forms for intervention reviews: RCTs only, version 3. 2014. Accessed 15 May 2019.

  31. 31.

    Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. 2011. Accessed 25 Jan 2019.

  32. 32.

    DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.

    CAS  PubMed  Google Scholar 

  33. 33.

    Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol. 1992;45:769–73.

    CAS  PubMed  Google Scholar 

  34. 34.

    Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

    PubMed  PubMed Central  Google Scholar 

  35. 35.

    Londeree BR, Ames SA. Trend analysis of the % VO2 max-HR regression. Med Sci Sports. 1976;8:123–5.

    CAS  PubMed  Google Scholar 

  36. 36.

    Kelley GA, Kelley KS. Statistical models for meta-analysis: a brief tutorial. World J Methodol. 2012;2:27–32.

    PubMed  PubMed Central  Google Scholar 

  37. 37.

    Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    CAS  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56:455–63.

    CAS  PubMed  Google Scholar 

  39. 39.

    Mathur DN, Toriola AL. Twelve weeks jogging effects on selected cardiovascular risk factors in untrained healthy males. J Sports Med Phys Fitness. 1984;24:259–62.

    CAS  PubMed  Google Scholar 

  40. 40.

    Duncan JJ, Farr JE, Upton SJ, Hagan RD, Oglesby ME, Blair SN. The effects of aerobic exercise on plasma catecholamines and blood pressure in patients with mild essential hypertension. JAMA. 1985;254(18):2609–13.

    CAS  PubMed  Google Scholar 

  41. 41.

    Suter E, Marti B, Tschopp A, Wanner HU, Wenk C, Gutzwiller F. Effects of self-monitored jogging on physical fitness, blood pressure and serum lipids: a controlled study in sedentary middle-aged men. Int J Sports Med. 1990;11:425–32.

    CAS  PubMed  Google Scholar 

  42. 42.

    Blumenthal JA, Siegel WC, Appelbaum M. Failure of exercise to reduce blood pressure in patients with mild hypertension Results of a randomized controlled trial. JAMA. 1991;266:2098–104.

    CAS  PubMed  Google Scholar 

  43. 43.

    Albright CL, King AC, Taylor CB, Haskell WL. Effect of a six-month aerobic exercise training program on cardiovascular responsivity in healthy middle-aged adults. J Psychosom Res. 1992;36:25–36.

    CAS  PubMed  Google Scholar 

  44. 44.

    Rogers MW, Probst MM, Gruber JJ, Berger R, Boone JB Jr. Differential effects of exercise training intensity on blood pressure and cardiovascular responses to stress in borderline hypertensive humans. J Hypertens. 1996;14:1369–75.

    CAS  PubMed  Google Scholar 

  45. 45.

    Tsai JC, Chang WY, Kao CC, Lu MS, Chen YJ, Chan P. Beneficial effect on blood pressure and lipid profile by programmed exercise training in Taiwanese patients with mild hypertension. Clin Exp Hypertens. 2002;24:315–24.

    CAS  PubMed  Google Scholar 

  46. 46.

    Tsai JC, Liu JC, Kao CC, Tomlinson B, Kao PF, et al. Beneficial effects on blood pressure and lipid profile of programmed exercise training in subjects with white coat hypertension. Am J Hypertens. 2002;15:571–6.

    PubMed  Google Scholar 

  47. 47.

    Tsai JC, Yang HY, Wang WH, Hsieh MH, Chen PT, et al. The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension. Clin Exp Hypertens. 2004;26:255–65.

    PubMed  Google Scholar 

  48. 48.

    Krustrup P, Nielsen JJ, Krustrup BR, Christensen JF, Pedersen H, et al. Recreational soccer is an effective health-promoting activity for untrained men. Br J Sports Med. 2009;43:825–31.

    CAS  PubMed  Google Scholar 

  49. 49.

    Knoepfli-Lenzin C, Sennhauser C, Toigo M, Boutellier U, Bangsbo J, et al. Effects of a 12-week intervention period with football and running for habitually active men with mild hypertension. Scand J Med Sci Sports. 2010;20:72–9.

    PubMed  Google Scholar 

  50. 50.

    Krustrup P, Hansen PR, Andersen LJ, Jakobsen MD, Sundstrup E, et al. Long-term musculoskeletal and cardiac health effects of recreational football and running for premenopausal women. Scand J Med Sci Sports. 2010;20(Suppl 1):58–71.

    PubMed  Google Scholar 

  51. 51.

    Amin-Shokravi F, Rajabi R, Ziaee N. Exercise effects on risk of cardiovascular disease among Iranian women. Asian J Sports Med. 2011;2:37–43.

    PubMed  PubMed Central  Google Scholar 

  52. 52.

    Beck DT, Martin JS, Casey DP, Braith RW. Exercise training reduces peripheral arterial stiffness and myocardial oxygen demand in young prehypertensive subjects. Am J Hypertens. 2013;26:1093–102.

    PubMed  PubMed Central  Google Scholar 

  53. 53.

    Foulds HJ, Bredin SS, Charlesworth SA, Ivey AC, Warburton DE. Exercise volume and intensity: a dose-response relationship with health benefits. Eur J Appl Physiol. 2014;114:1563–71.

    PubMed  Google Scholar 

  54. 54.

    Hur S, Kim SR. The effects of exercise therapy on CVD risk factors in women. J Phys Ther Sci. 2014;26:1367–70.

    PubMed  PubMed Central  Google Scholar 

  55. 55.

    Patterson S, Pattison J, Legg H, Gibson AM, Brown N. The impact of badminton on health markers in untrained females. J Sports Sci. 2017;35:1098–106.

    PubMed  Google Scholar 

  56. 56.

    Jamnik VK, Warburton DE, Makarski J, McKenzie DC, Shephard RJ, et al. Enhancing the effectiveness of clearance for physical activity participation: background and overall process. Appl Physiol Nutr Metab. 2011;36(Suppl 1):S3–13.

    PubMed  Google Scholar 

  57. 57.

    Boutcher YN, Boutcher SH. Exercise intensity and hypertension: what’s new? J Hum Hypertens. 2017;31:157–64.

    CAS  PubMed  Google Scholar 

  58. 58.

    Annuk M, Zilmer M, Fellström B. Endothelium-dependent vasodilation and oxidative stress in chronic renal failure: impact on cardiovascular disease. Kidney Int Suppl. 2003;63:S50–3.

    Google Scholar 

  59. 59.

    Korsager LM, Matchkov VV. Hypertension and physical exercise: The role of oxidative stress. Medicina (Kaunas). 2016;52:19–27.

    Google Scholar 

  60. 60.

    Sachdev S, Davies KJ. Production, detection, and adaptive responses to free radicals in exercise. Free Radic Biol Med. 2008;44:215–23.

    CAS  PubMed  Google Scholar 

  61. 61.

    Arakawa K. Antihypertensive mechanism of exercise. J Hypertens. 1993;11:223–9.

    CAS  PubMed  Google Scholar 

Download references


The authors wish to sincerely thank the staff of Osaka University of Health and Sports Sciences Library for collecting the articles used in this analysis and to thank the staff of International Studies Library in Osaka University, National Institute of Public Health, and Chukyo University Library for facilitating a search of the literature in electronic databases.

Author information



Corresponding author

Correspondence to Yutaka Igarashi.

Ethics declarations


No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Yutaka Igarashi and Yoshie Nogami have no conflicts of interest relevant to the content of this article.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 381 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Igarashi, Y., Nogami, Y. Running to Lower Resting Blood Pressure: A Systematic Review and Meta-analysis. Sports Med 50, 531–541 (2020).

Download citation