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 efect 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 infuence of combined therapy on echocardiogram parameters and BP. A signifcance level of 5% and 95% CI was considered for all outcomes. Results Five studies (N = 1738) were included in meta-analysis. Combined therapy decreased signifcantly 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.