{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:20:25Z","timestamp":1787696425570,"version":"build-2784847793"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This analysis aims to estimate the comparative efficacy of anti-hypertensive medications and exercise interventions on systolic and diastolic blood pressure reduction in people with hypertension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic review was conducted focusing on randomised controlled trials (RCTs) of exercise interventions and first-line anti-hypertensives where blood pressure reduction was the primary outcome in those with hypertension. Network meta-analyses were conducted to generate estimates of comparative efficacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 93 RCTs (N\u2009=\u200932,404, mean age in RCTs: 39\u201370 years) which compared placebo or usual care with first-line antihypertensives including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers and thiazide-like diuretics and exercise interventions including aerobic training and dynamic resistance training. Of these, there were 81 (87%) trials related to medications (n\u2009=\u200931,347, 97%) and 12 (13%) trials related to exercise (n\u2009=\u20091057, 3%). The point estimates suggested that antihypertensive medications were more effective than exercise but there was insufficient evidence to suggest that first-line medications significantly reduced blood pressure to a greater extent than did the exercise interventions. Of the first-line treatments, angiotensin receptor blockers and calcium channel blockers had the highest treatment ranking, while exercise had the second lowest treatment ranking, followed by control conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The current evidence base with a bias towards medication research may partly explain the circumspection around the efficacy of exercise in guidelines and practice. Clinicians may justifiably consider exercise for low risk hypertension patients who confirm a preference for such an approach.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487319879786","type":"journal-article","created":{"date-parts":[[2019,10,16]],"date-time":"2019-10-16T06:17:30Z","timestamp":1571206650000},"page":"247-255","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":63,"title":["Comparative efficacy of exercise and anti-hypertensive pharmacological interventions in reducing blood pressure in people with hypertension: A network meta-analysis"],"prefix":"10.1093","volume":"27","author":[{"given":"Chris","family":"Noone","sequence":"first","affiliation":[{"name":"School of Psychology , National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Leahy","sequence":"additional","affiliation":[{"name":"The National Centre for Pharmacoeconomics , Saint James's Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eimear C","family":"Morrissey","sequence":"additional","affiliation":[{"name":"School of Psychology , National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Newell","sequence":"additional","affiliation":[{"name":"School of Mathematics , Statistics, and Applied Mathematics, National University of Ireland Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miche\u00e1l","family":"Newell","sequence":"additional","affiliation":[{"name":"School of Medicine , National University of Ireland Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P","family":"Dwyer","sequence":"additional","affiliation":[{"name":"School of Psychology , National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Murphy","sequence":"additional","affiliation":[{"name":"School of Psychology , National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Psychology , Royal College of Surgeons in Ireland, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W","family":"Murphy","sequence":"additional","affiliation":[{"name":"Discipline of General Practice , School of Medicine, National University of Ireland Galway, Ireland"},{"name":"HRB Primary Care Clinical Trial Network Ireland , National University of Ireland Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard J","family":"Molloy","sequence":"additional","affiliation":[{"name":"School of Psychology , National University of Ireland, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,29]]},"reference":[{"key":"2024042315344512600_bibr1-2047487319879786","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur Heart J"},{"key":"2024042315344512600_bibr2-2047487319879786","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1177\/2047487317702042","article-title":"The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. 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