What are the benefits and harms of walking to prevent and control hypertension?

Walking for hypertension – Cochrane Database of Systematic Reviews 2021 – LINK


Clinical Answer:
Walking at home, in the community, or in a laboratory environment is associated with a reduction in systolic blood pressure (moderate‐certainty evidence), as well as in diastolic blood pressure and heart rate (low‐certainty evidence), compared with no intervention.

Information regarding adverse events and withdrawals due to adverse events was limited, but when adverse events were reported, they were rare, and most were related to physical injury.

For people aged 16 and older, moderate‐certainty evidence shows that three to five weekly moderate‐intensity walking sessions of 20 to 40 minutes per session lowered systolic blood pressure over an average 15‐week period (mean difference of around 4.11 mmHg) compared with no intervention. A similar reduction was observed in all age groups above 16 years and in both genders. Low‐certainty evidence suggests that walking lowered diastolic pressure (mean difference of around 1.79 mmHg) and heart rate (mean difference of around 2.76 bpm). A limited number of studies reported adverse events and withdrawals due to adverse events, and these studies posed high risk of bias. Knee pain or injury was the most commonly reported adverse event.

Population

People (mean age 16‐84 years [approximately 51% aged over 60 years old], ratio of males to females 1:1.5) recruited by trials conducted worldwide. In 17 RCTs, participants recruited were hypertensive while 15 RCTs recruited non‐hypertensive participants only

Intervention

Walking at home/in the community (50 RCTs) or in a laboratory environment (16 RCTs), where reported, for 4‐64 weeks (average 15 weeks). Exact details of walking interventions varied widely and included treadmill walking, outdoor walking, brisk walking, and Nordic walking. Most trials prescribed 3‐5 moderate intensity walking sessions per week and 20‐40 minutes per session (average walking time per week of 153 minutes)

Comparator
No intervention (maintain normal activity habits)