Effect of exercise training on the renin–angiotensin–aldosterone system: a meta–analysis

Author(s)
Baffour-Awuah, Biggie
Man, Melody
Goessler, Karla F
Cornelissen, Véronique A
Dieberg, Gudrun
Smart, Neil A
Pearson, Melissa J
Publication Date
2024
Abstract
<p>Blood pressure (BP) management reduces the risk of cardiovascular disease (CVD). The renin–angiotensin–aldosterone system (RAAS) plays an important role in regulating and maintaining blood volume and pressure. This analysis aimed to investigate the effect of exercise training on plasma renin, angiotensin-II and aldosterone, epinephrine, norepinephrine, urinary sodium and potassium, BP and heart rate (HR). We systematically searched PubMed, Web of Science, and the Cochrane Library of Controlled Trials until 30 November 2022. The search strategy included RAAS key words in combination with exercise training terms and medical subject headings. Manual searching of reference lists from systematic reviews and eligible studies completed the search. A random effects meta-analysis model was used. Eighteen trials with a total of 803 participants were included. After exercise training, plasma angiotensin-II (SMD −0.71" 95% CI −1.24, −0.19" <i>p</i> = 0.008" <i>n</i> = 9 trials), aldosterone (SMD −0.37" 95% CI −0.65, −0.09" <i>p</i> = 0.009" <i>n</i> = 8 trials) and norepinephrine (SMD −0.82" 95% CI −1.18, −0.46" <i>p</i> < 0.001" <i>n</i> = 8 trials) were reduced. However, plasma renin activity, epinephrine, and 24-h urinary sodium and potassium excretion remained unchanged with exercise training. Systolic BP was reduced (MD −6.2 mmHg" 95% CI −9.9, −2.6" <i>p</i> = 0.001) as was diastolic BP (MD −4.5 mmHg" 95% CI −6.9, −2.1" <i>p</i> < 0.001) but not HR (MD −3.0 bpm" 95% CI −6.0, 0.4" <i>p</i> = 0.053). Exercise training may reduce some aspects of RAAS and sympathetic nervous system activity, and this explains some of the anti-hypertensive response.</p>
Citation
Journal of Human Hypertension, v.38, p. 89-101
ISSN
1476-5527
0950-9240
Link
Publisher
Nature Publishing Group
Rights
Attribution 4.0 International
Title
Effect of exercise training on the renin–angiotensin–aldosterone system: a meta–analysis
Type of document
Journal Article
Entity Type
Publication

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