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Exercise dose and modality for blood pressure reduction in predominantly postmenopausal women: a dose-response network meta-analysis
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DOI：10.3389/fmed.2026.1918407.png)
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Abstract
En 中文
BackgroundBlood pressure rises during the menopausal transition and postmenopause; yet exercise guidance seldom specifies the type and dose most effective for lowering it. We examined the dose-response relationship between exercise and blood pressure in trials enrolling peri- or postmenopausal women; while recognizing that the available evidence was predominantly derived from postmenopausal populations.MethodsWe searched PubMed; Web of Science; Embase; and the Cochrane CENTRAL register from inception to March 2026 for randomized controlled trials of exercise interventions lasting at least 4 weeks in peri- or postmenopausal women. To limit dose misclassification; weekly dose was derived only from trials that reported exercise frequency; intensity; and session duration; expressed as METs-min/week and adjusted for attendance where this was reported. A Bayesian model-based dose-response network meta-analysis was fitted; with risk of bias assessed using RoB 2 and certainty of evidence using CINeMA.ResultsSeventy-four trials involving 3; 573 women (mean age; 59.5 years) were included; 70 exclusively enrolled postmenopausal women and four included perimenopausal women. Among eight candidate dose-response functions; the quadratic model yielded the lowest DIC and was retained as the primary model. Under this model; the largest predicted reductions occurred at 1; 400 METs-min/week for SBP (−6.70 mmHg; 95% credible interval −9.18 to −4.29) and 1; 500 METs-min/week for DBP (−4.20 mmHg; −6.52 to −1.74). The apparent attenuation at higher doses was model-dependent. At the highest observed AQE dose of 800 METs-min/week; aquatic exercise produced the largest model-estimated point reductions for both outcomes (systolic −11.63 mmHg; diastolic −7.73 mmHg); however; these estimates were based on only three AQE intervention arms and the ranking should be considered exploratory. Meta-regression found no significant moderation by age; baseline blood pressure; or intervention length. Certainty of evidence ranged from very low to low.ConclusionAmong trial populations composed predominantly of postmenopausal women; exercise was associated with a non-linear; dose-related reduction in blood pressure. The largest model-estimated reductions occurred near 1; 400–1; 500 METs-min/week. Aquatic exercise appeared promising; but the small number of contributing trials and the generally low certainty of evidence preclude definitive modality ranking. Evidence remains insufficient to draw stage-specific conclusions for perimenopausal women.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/; identifier [CRD420261354599].
Keywords:
hypertension
exercise
network meta-analysis
blood pressure
menopause
Journal
F
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3
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2.1W
Citations:
4.0W
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