24 Sep Best exercise to prevent stroke recurrence
It can be as effective as taking antihypertensives
Stroke patients can improve their blood pressure and reduce their risk of repeat strokes with exercise, according to a review.
Even with limited mobility, any kind of exercise is worth the effort, say the UK study authors — particularly if it’s aerobic and initiated early.
The team pooled data from 20 studies that evaluated exercise programs after a stroke or transient ischemic attack.
Altogether, the studies involved 1031 patients from 10 countries.
Some focused on aerobic exercise, while others evaluated resistance exercises aimed at improving muscle strength or endurance.
Blood pressure reductions from exercise mirrored what would be expected from taking antihypertensives, the team found.
The researchers found that stroke patients who exercised — particularly aerobically — reduced both their systolic and diastolic measures by several points compared with sedentary people.
Exercise also improved cholesterol levels, but it had no effect on blood glucose levels after overnight fasting, or on BMI.
Blood pressure reductions were most significant for those who started exercising within six months of their stroke. – with Reuters
Aerobic exercise interventions reduce blood pressure in patients after stroke or transient ischaemic attack: a systematic review and meta-analysis
- Cheng Wang
- Jessica Redgrave
- Mohsen Shafizadeh
- Arshad Majid
- Karen Kilner
- Ali N Ali
Objective Secondary vascular risk reduction is critical to preventing recurrent stroke. We aimed to evaluate the effect of exercise interventions on vascular risk factors and recurrent ischaemic events after stroke or transient ischaemic attack (TIA).
Design Intervention systematic review and meta-analysis.
Data sources OVID MEDLINE, PubMed, The Cochrane Library, Web of Science, The National Institute for Health and Care Excellence, TRIP Database, CINAHL, PsycINFO, SCOPUS, UK Clinical Trials Gateway and the China National Knowledge Infrastructure were searched from 1966 to October 2017.
Eligibility criteria Randomised controlled trials evaluating aerobic or resistance exercise interventions on vascular risk factors and recurrent ischaemic events among patients with stroke or TIA, compared with control.
Results Twenty studies (n=1031) were included. Exercise interventions resulted in significant reductions in systolic blood pressure (SBP) −4.30 mm Hg (95% CI −6.77 to −1.83) and diastolic blood pressure −2.58 mm Hg (95% CI −4.7 to −0.46) compared with control. Reduction in SBP was most pronounced among studies initiating exercise within 6 months of stroke or TIA (−8.46 mm Hg, 95% CI −12.18 to −4.75 vs −2.33 mm Hg, 95% CI −3.94 to −0.72), and in those incorporating an educational component (−7.81 mm Hg, 95% CI −14.34 to −1.28 vs −2.78 mm Hg, 95% CI −4.33 to −1.23). Exercise was also associated with reductions in total cholesterol (−0.27 mmol/L, 95% CI −0.54 to 0.00), but not fasting glucose or body mass index. One trial reported reductions in secondary vascular events with exercise, but was insufficiently powered.
Summary Exercise interventions can result in clinically meaningful blood pressure reductions, particularly if initiated early and alongside education.