Aerobic Activity Significantly Reduces Blood Pressure Among Hypertensive Adults in Africa: A Systematic Review and Meta-Analysis

Titus Robert Leeyio¹Nicholas Philip Katto¹Faiza Mohamed Juma¹Farida Iddy Mkassy¹Anthony Cuthbert Liwa¹Sarah Shali Matuja¹Daniel Byamungu¹Philip Ayieko²Deogratius Bintabara³Eveline Thobias Konje^1*

• ¹Catholic University of Health and Allied Sciences (CUHAS), Bugando, Tanzania
• ²Mwanza Intervention Trials Unit, Mwanza, Tanzania
• ³University of Dodoma, Dodoma, Tanzania

Background: Sub-Saharan Africa is faced with the increasing prevalence of high blood pressure, with projections estimating 216.8 million people by 2030. Aerobic activity has been recognized for its cardiovascular benefits. However, its effect remains under-explored and findings are largely inconsistent. Hence, this review aimed to estimate the overall effect of aerobic activity among hypertensive adults on medication in Africa.Methods: African-based randomized clinical trials published between 2000 and September 2024 comprising hypertensive adults 18 obtained from PubMed, African Journal Online, Hinari, and Science Direct databases were eligible for the study. In addition, the Cochrane Risk of Bias tool (ROBIS-2) was used for quality assessment.Results: Of 683 articles identified, eight qualified for qualitative assessment with 1,112 participants on antihypertensive medication (625 in the intervention group and 487 in the control group). Followup of participants ranged from 6 to 16 weeks with different aerobic modalities such as brisk walking, dance and bicycle ergometer, which were done either continuously or at different time intervals (3 times per week) that lasted between 30 and 60 minutes. Overall risk of bias was moderate and the intensity of the training was based on VO2Max (64% to 79%) and VO2Peak (40% to 79%). Main findings suggest a significant pooled reduction in systolic blood pressure, MD: -5.40mmHg, [95% CI: -9.05 --1.75] and a modest reduction in diastolic blood pressure, MD: -1.90mmHg, [95% CI: -3.81 -0.01]. Subgroup analysis indicated stronger effects in interventions lasting for at least 8 weeks than those implemented for more than 8 weeks.Our finding shows that, adherence to anti-hypertensive medications in addition to aerobic activity effectively reduced blood pressure among hypertensive adults in Africa, particularly at 8 weeks with slightly diminished effect in prolonged weeks. It is therefore imperative to conduct further studies in this area of hypertension management.