Resistance training and blood pressure: Insights from a meta-analysis of the aging population

Background: Hypertension is a prevalent cardiovascular risk factor in older adults, contributing to morbidity and mortality worldwide. While aerobic exercise is well-established for blood pressure (BP) management, the role of resistance training (RT) in aging populations remains less clear, with inconsistent findings across studies. Objective: To evaluate the effect of RT on BP in adults aged 60 and older and explore moderators such as intervention duration, gender, and session frequency. Method: Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar for randomized controlled trials (RCTs) of RT (>= 4 weeks) in older adults (mean age >= 60 years), published until February 2025. Data on systolic, diastolic, and mean BP were pooled using random-effects models, with subgroup and meta-regression analyses to assess heterogeneity sources. Results: Fifty-one RCTs (n = 2025) demonstrated that RT significantly reduced systolic BP (MD = -6.11 mmHg), diastolic BP (MD = -2.53 mmHg), and mean BP (MD = -4.10 mmHg; all p < 0.001). Subgroup analysis revealed larger systolic (females: -7.95 mmHg; males: -6.02 mmHg, NS) and diastolic BP reductions (females: -4.24 mmHg; males: -3.39 mmHg, NS), with mean BP reduced significantly in both sexes (females: -4.02 mmHg; males: -7.08 mmHg). Short-term (<= 12 weeks) and higher frequency interventions enhanced BP reductions. Heterogeneity was high but sensitivity analyses confirmed robustness. Conclusion: RT effectively lowers BP in older adults, supporting its inclusion in hypertension management strategies. Short-term, frequent RT protocols may optimize outcomes, particularly for females. Further research is needed to explore long-term effects and underlying mechanisms.