The effect of resistance training on blood pressure and resting heart rate in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials

Abstract

This meta-analysis assessed the impacts of resistance training on hemodynamic outcomes, including blood pressure and heart rate, in patients with type 2 diabetes (T2D). Four databases were searched following PRISMA guidelines. Randomized controlled trials (RCTs) comparing resistance training to usual care were included if they evaluated systolic and diastolic blood pressure (SBP and DBP), heart rate, and maximum oxygen uptake (VO_2max) in adults with T2D. Random-effects models were used to calculate mean differences, with corresponding 95 % confidence intervals (CIs). Twenty-six RCTs were included. Resistance training significantly reduced SBP by −4.13 mmHg (95 % CI: −6.40, −1.85; p = 0.0004) and DBP by −2.03 mmHg (95 % CI: −3.69, −0.38; p = 0.02), with greater reductions in interventions lasting over 12 weeks. Resting heart rate decreased by −3.17 bpm (95 % CI: −6.33, −0.01; p = 0.05) and VO_2max improved by 0.27 ml/kg/min (95 % CI: 0.02, 0.53; p = 0.04). Meta-regression revealed that intervention duration, session frequency, and study quality did not significantly explain the observed heterogeneity. Resistance training effectively improves hemodynamic outcomes T2D patients, but high heterogeneity in blood pressure outcomes and limited subgroup data on specific subgroups (e.g., women) restrict generalizability. Further research should explore heterogeneity sources and optimize resistance training protocols.