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Physical Exercise Combined with Antihypertensive Drug Therapy on Left Ventricular Hypertrophy: Systematic Review and Meta-Analysis

Abstract

Introduction

Physical exercise and antihypertensive drugs contribute to reduce or prevent hypertensive heart disease (HHD). The effect on blood pressure (BP) of both combined therapy is well documented, but not for the left ventricular (LV) function.

Aim

A systematic review and meta-analysis was conducted for LV biomarkers analysis regarding to HHD on subjects treated with antihypertensive drugs combined with physical exercise practice.

Methods

The search was conducted on the Pubmed, Bireme, Lilacs, Central (Cochrane) and Science direct databases, comprising undetermined period of time, including randomized studies comparing trained and sedentary subjects, both treated with antihypertensive drugs. We analyzed the influence of combined therapy on echocardiogram parameters and BP. A significance level of 5% and 95% CI was considered for all outcomes.

Results

Five studies (N = 1738) were included in meta-analysis. Combined therapy decreased significantly LV mass (CI − 21.63 to − 1.81, N = 783) and heart rate (HR; CI − 4.23 to − 1.59, N = 1738), compared to antihypertensive drugs alone. There was a trend to decrease LV mass index (LVMI; CI − 5.57 to 0.71, N = 1674), systolic BP (CI − 2.47 to 1.23, N = 1674) and diastolic BP (CI − 2.16 to 0.28, N = 1674), a trend to increase of ejection fraction (EF; 95% CI − 0.50 to 2.12, N = 783) and LV end-diastolic diameter (CI − 0.85 to 0.92, N = 847) was similar.

Conclusion

The antihypertensive therapy combined with physical exercise practice can reduce LV mass and HR. Therefore, combined therapy prescription should be considered for prevention and treatment of LV hypertrophy of hypertensive subjects.

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Correspondence to Andrea Grabe-Guimarães.

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This article is part of the Ph.D. thesis work performed by Quênia Janaína Tomaz de Castro, at Pharmaceutical Science Program at School of Pharmacy, UFOP.

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de Castro, Q.J.T., Tomaz, F.S.C., Watai, P.Y. et al. Physical Exercise Combined with Antihypertensive Drug Therapy on Left Ventricular Hypertrophy: Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev 27, 493–503 (2020). https://doi.org/10.1007/s40292-020-00403-z

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Keywords

  • Left ventricular hypertrophy
  • Hypertension
  • Physical exercise
  • Antihypertensive drugs
  • Meta-analysis