Comparative efficacy of various exercise modalities on blood pressure in patients with metabolic syndrome: A systematic review and dose-response network meta-analysis of randomized controlled trials.

This study investigated the dose-response relationships between different exercise modalities and blood pressure in individuals with metabolic syndrome. The review was conducted in accordance with PRISMA-NMA guidelines. Electronic databases, including PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials, were systematically searched for randomized controlled trials. Bayesian network and dose-response meta-analyses were performed. A total of 28 studies were included, with a total of 2084 participants, of whom 49.5% were women, with a mean age of 55 (standard deviation = 7.03) years and a mean body mass index of 31.68 (standard deviation = 3.62) kg/m2. Aerobic exercise, combined aerobic and resistance training, mind-body exercise, and high-intensity interval training were significantly associated with reductions in systolic blood pressure. High-intensity interval training at 690 metabolic equivalent minutes per week was the most effective modality and dose (-5.07 mmHg, 95% CrI -9.20, -0.92). For diastolic blood pressure, both aerobic exercise and high-intensity interval training were significantly associated with reductions, with high-intensity interval training at 830 metabolic equivalent minutes per week showing the greatest effect (-4.42 mmHg, 95% CrI -8.4, -0.33). Subgroup analyses suggested greater effects among participants with hypertension and in interventions lasting ≥16 weeks. This dose-response network meta-analysis identified nine exercise prescriptions for effective blood pressure management in metabolic syndrome. Further studies are needed to validate the recommended dose ranges. PROSPERO REGISTRATION NUMBER: CRD420261288594.