Evaluating the Effect of Exercise Training on Systolic and Diastolic Blood Pressure in Older Adults with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
https://doi.org/10.22054/nass.2026.94875.1250
Ahmad Ashour Abbas Al-Omairi, Farnaz Seifi Asgshahr, Reza Farzizadeh
Abstract Background: Older adults with T2DM face high risk hypertension. Exercise recommended for BP control, its effects on SBP DBP in this population, alongside moderators, remain unclear. This meta-analysis aimed to determine effect exercise training on SBP and DBP in diabetic older adults and identify moderating factors, specifically session frequency and duration.
Methods: PubMed, Scopus, Web of Science, Cochrane Library searched for RCTs and controlled interventions published from January 2010 to early 2026. Primary outcomes were SBP and DBP. Random-effects model used, effect size reported as SMD and 95% CI. Subgroup analyses based on weekly session frequency (≤2 vs. >2) and session duration (≤50 vs. >50 minutes).
Results: 34 studies (2,847 participants) analyzed. Exercise showed no significant effect on SBP (SMD = -0.132, p = 0.328). Effect on DBP was borderline non-significant (SMD = 0.223, p = 0.064). Subgroup analyses revealed significant DBP increases for ≤2 sessions/week (p = 0.003) and ≤50 minutes (p = 0.013). Heterogeneity high (I² > 74%).
Conclusion: Exercise did not significantly reduce SBP or DBP in older adults with T2DM. Paradoxical DBP rise in low frequency short duration subgroups requires investigation. Findings suggest other factors (intensity, type, medication) may be more critical than session frequency or duration alone.