Optimizing exercise prescription for blood pressure control after stroke or transient ischemic attack: A systematic review and meta-analysis.

Abstract

This study aimed to examine the dose-response relationships between different exercise modalities and blood pressure reduction in individuals after stroke or transient ischemic attack METHODS: Searches were performed in PubMed (1946), Web of Science (1975), Cochrane CENTRAL (1992), and EMBASE (1971) from inception up to December 10, 2025. Exercise dose was calculated as the product of duration, frequency, and intensity, expressed in metabolic equivalents of task minutes per week (METs-min/week). A total of 25 studies were included in the review. Aerobic exercise produced the greatest reductions in systolic blood pressure (SBP) at 590 METs-min/week (-3.79 mmHg, 95% CrI: -5.95, -1.86) and diastolic blood pressure (DBP) at 520 METs-min/week (-1.91 mmHg, 95% CrI: -3.56, -0.33). For combined aerobic and resistance training, the optimal doses were 780 METs-min/week for SBP (-7 mmHg, 95% CrI: -10.05, -3.87) and 660 METs-min/week for DBP (-3.58 mmHg, 95% CrI: -6.04, -1.23). Relative ranking analyses indicated that combined aerobic and resistance training at 780 METs-min/week and 660 METs-min/week produced the greatest reductions in SBP and DBP, respectively. These findings support evidence-based exercise prescriptions for blood pressure management in this high-risk population.