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Published in: Sports Medicine 7/2018

01-07-2018 | Systematic Review

Aquatic Training in Upright Position as an Alternative to Improve Blood Pressure in Adults and Elderly: A Systematic Review and Meta-Analysis

Authors: Thaís Reichert, Rochelle Rocha Costa, Bruna Machado Barroso, Vitória de Mello Bones da Rocha, Rodrigo Sudatti Delevatti, Luiz Fernando Martins Kruel

Published in: Sports Medicine | Issue 7/2018

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Abstract

Background

Meta-analyses have shown that land training (LT) reduces blood pressure; however, it is not known whether aquatic training (AT) promotes this same effect.

Objective

The aim was to conduct a meta-analysis on the effects of AT on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults and elderly and compare them to those of LT and no training [control group (CG)].

Data Sources

Embase, PubMed, Cochrane and Scopus were searched up to May 2017.

Study Eligibility Criteria

Studies that evaluated the effect of upright AT (i.e., AT performed in upright position) on the blood pressure of adult individuals and the elderly who did not present with cardiovascular disease (other than hypertension) were included.

Data Analysis

Two independent reviewers screened search results, performed data extraction and assessed risk of bias. Random effect was used, and the effect size (ES) was calculated by using the standardized mean difference with a 95% confidence interval.

Results

AT promoted a reduction in SBP (ES − 1.47; 95% CI − 2.23 to − 0.70; p < 0.01) compared to CG. This effect is maintained with training progression (ES − 1.52; 95% CI − 2.70 to − 0.33; p = 0.01) and no progression (ES − 1.43; 95% CI − 2.64 to − 0.23; p = 0.02). These effects were significant only in hypertensive (ES − 2.20; 95% CI − 2.72 to − 1.68; p < 0.01), and not in pre-hypertensive individuals. AT promoted a decrease in DBP (− 0.92; 95% CI − 1.27 to − 0.57; p < 0.01) after training with progression (− 0.81; 95% CI − 1.62 to − 0.001; p = 0.04) and no progression (− 1.01; 95% CI − 1.40 to − 0.62; p < 0.01) in pre-hypertensive (− 1.12; 95% CI − 1.53 to − 0.70; p < 0.01) and hypertensive patients (− 0.69; 95% CI − 1.31 to − 0.06; p = 0.03). AT promoted similar reductions in SBP compared to LT; however, reduction of DBP in hypertensive patients was lower (1.82; 95% CI 0.84 to 2.79; p < 0.01).

Conclusion

AT promotes blood pressure reduction in adults and elderly. The reduction in SBP in those performing AT is similar to those performing LT, but reduction of DBP is lower in the AT group compared to that in the LT group.

Systematic Review Registration Number

CRD42016049716.
Appendix
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Literature
1.
go back to reference Boutcher YN, Boutcher SH. Exercise intensity and hypertension: what’s new? J Hum Hypertens. 2017;31:157–64.CrossRefPubMed Boutcher YN, Boutcher SH. Exercise intensity and hypertension: what’s new? J Hum Hypertens. 2017;31:157–64.CrossRefPubMed
2.
go back to reference Brown RE, Riddell MC, Macpherson AK, Canning KL, Kuk JL. The joint association of physical activity, blood-pressure control, and pharmacologic treatment of hypertension for all-cause mortality risk. Am J Hypertens. 2013;26:1005–10.CrossRefPubMed Brown RE, Riddell MC, Macpherson AK, Canning KL, Kuk JL. The joint association of physical activity, blood-pressure control, and pharmacologic treatment of hypertension for all-cause mortality risk. Am J Hypertens. 2013;26:1005–10.CrossRefPubMed
3.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.CrossRefPubMed
4.
go back to reference Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013;310:959–68.CrossRefPubMed Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013;310:959–68.CrossRefPubMed
5.
go back to reference Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004;36:533–53.CrossRefPubMed Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004;36:533–53.CrossRefPubMed
6.
go back to reference Pescatello LS, MacDonald HV, Lamberti L, Johnson BT. Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep. 2015;17:87.CrossRefPubMedPubMedCentral Pescatello LS, MacDonald HV, Lamberti L, Johnson BT. Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep. 2015;17:87.CrossRefPubMedPubMedCentral
7.
go back to reference Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51:1403–19.CrossRefPubMed Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51:1403–19.CrossRefPubMed
8.
go back to reference Gonzaga CC, Calhoun DA. American Heart Association Statement on diagnosis, evaluation, and treatment of resistant hypertension: what should we remember in everyday practice? Pol Arch Med Wewn. 2008;118:396–7.PubMed Gonzaga CC, Calhoun DA. American Heart Association Statement on diagnosis, evaluation, and treatment of resistant hypertension: what should we remember in everyday practice? Pol Arch Med Wewn. 2008;118:396–7.PubMed
9.
go back to reference Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfeld MJ, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens. 2009;27:2121–58.CrossRefPubMed Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfeld MJ, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens. 2009;27:2121–58.CrossRefPubMed
10.
go back to reference Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2000;35:838–43.CrossRefPubMed Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2000;35:838–43.CrossRefPubMed
11.
go back to reference Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493–503.CrossRefPubMed Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493–503.CrossRefPubMed
12.
go back to reference Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–8.CrossRefPubMed Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–8.CrossRefPubMed
13.
go back to reference Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. JAMA. 2013;2:e004473. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. JAMA. 2013;2:e004473.
14.
go back to reference Delevatti RS, Marson E, Kruel LF. Effect of aquatic exercise training on lipids profile and glycaemia: a systematic review. Rev Andal Med Deporte. 2015;8:163–70.CrossRef Delevatti RS, Marson E, Kruel LF. Effect of aquatic exercise training on lipids profile and glycaemia: a systematic review. Rev Andal Med Deporte. 2015;8:163–70.CrossRef
15.
go back to reference Pendergast DR, Moon RE, Krasney JJ, Held HE, Zamparo P. Human physiology in an aquatic environment. Compr Physiol. 2015;5:1705–50.CrossRefPubMed Pendergast DR, Moon RE, Krasney JJ, Held HE, Zamparo P. Human physiology in an aquatic environment. Compr Physiol. 2015;5:1705–50.CrossRefPubMed
16.
go back to reference Epstein M. Cardiovascular and renal effects of head-out water immersion in man: of the model in the assessment of volume homeostasis. Circ Res. 1976;39:619–28.CrossRefPubMed Epstein M. Cardiovascular and renal effects of head-out water immersion in man: of the model in the assessment of volume homeostasis. Circ Res. 1976;39:619–28.CrossRefPubMed
17.
go back to reference Epstein M. Renal effects of head-out water immersion in humans: a 15-year update. Physiol Rev. 1992;72:563–621.CrossRefPubMed Epstein M. Renal effects of head-out water immersion in humans: a 15-year update. Physiol Rev. 1992;72:563–621.CrossRefPubMed
18.
go back to reference Pendergast DR, Lundgren CEG. The underwater environment: cardiopulmonary, thermal, and energetic demands. J Appl Physiol. 2009;106:276–83.CrossRefPubMed Pendergast DR, Lundgren CEG. The underwater environment: cardiopulmonary, thermal, and energetic demands. J Appl Physiol. 2009;106:276–83.CrossRefPubMed
19.
go back to reference Gabrielsen A, Pump B, Bie P, Christensen NJ, Warberg J, Nor SKP. Atrial distension, haemodilution, and acute control of renin release during water immersion in humans. Acta Physiol Scand. 2002;174:91–9.CrossRefPubMed Gabrielsen A, Pump B, Bie P, Christensen NJ, Warberg J, Nor SKP. Atrial distension, haemodilution, and acute control of renin release during water immersion in humans. Acta Physiol Scand. 2002;174:91–9.CrossRefPubMed
20.
go back to reference Carvalho-Filho MA, Carvalheira JB, Velloso LA, Saad MJ. Cross-talk das vias de sinalização de insulina e angiotensina II: implicações com a associaçãoentre diabetes mellitus e hipertensão arterial e doença cardiovascular. Arq Bras Endocrinol Metab. 2007;51:195–203.CrossRef Carvalho-Filho MA, Carvalheira JB, Velloso LA, Saad MJ. Cross-talk das vias de sinalização de insulina e angiotensina II: implicações com a associaçãoentre diabetes mellitus e hipertensão arterial e doença cardiovascular. Arq Bras Endocrinol Metab. 2007;51:195–203.CrossRef
21.
go back to reference Riet LT, van Esch JH, Roks AJ, van den Meiracker AH, Danser AH. Hypertension: renin–angiotensin–aldosterone system alterations. Circ Res. 2015;116:960–75.CrossRef Riet LT, van Esch JH, Roks AJ, van den Meiracker AH, Danser AH. Hypertension: renin–angiotensin–aldosterone system alterations. Circ Res. 2015;116:960–75.CrossRef
22.
go back to reference Colado JC, Triplett NT, Tella V, Saucedo P, Abellán J. Effects of aquatic resistance training on health and fitness in postmenopausal women. Eur J Appl Physiol. 2009;106:113–22.CrossRefPubMed Colado JC, Triplett NT, Tella V, Saucedo P, Abellán J. Effects of aquatic resistance training on health and fitness in postmenopausal women. Eur J Appl Physiol. 2009;106:113–22.CrossRefPubMed
23.
go back to reference Lambert BS, Greene NP, Carradine AT, Joubert DP, Fluckey JD, Riechman SE, et al. Aquatic treadmill training reduces blood pressure reactivity to physical stress. Med Sci Sports Exerc. 2014;46:809–16.CrossRefPubMed Lambert BS, Greene NP, Carradine AT, Joubert DP, Fluckey JD, Riechman SE, et al. Aquatic treadmill training reduces blood pressure reactivity to physical stress. Med Sci Sports Exerc. 2014;46:809–16.CrossRefPubMed
24.
go back to reference Piotrowska-Całka E. Effects of a 24-week deep water aerobic training program on cardiovascular fitness. Biol Sport. 2010;27:95–8.CrossRef Piotrowska-Całka E. Effects of a 24-week deep water aerobic training program on cardiovascular fitness. Biol Sport. 2010;27:95–8.CrossRef
25.
go back to reference Nuttamonwarakul A, Amatyakul S, Suksom D. Twelve weeks of aqua-aerobic exercise improve physiological adaptations and glycemic control in elderly patients with type 2 diabetes. J Exerc Physiol Online. 2012;2:64–70. Nuttamonwarakul A, Amatyakul S, Suksom D. Twelve weeks of aqua-aerobic exercise improve physiological adaptations and glycemic control in elderly patients with type 2 diabetes. J Exerc Physiol Online. 2012;2:64–70.
26.
go back to reference Arca EA, Martinelli B, Martin LC, Waisberg CB, Franco RJ. Aquatic exercise is as effective as dry land training to blood pressure reduction in postmenopausal hypertensive women. Physiother Res Int. 2014;19:93–8.CrossRefPubMed Arca EA, Martinelli B, Martin LC, Waisberg CB, Franco RJ. Aquatic exercise is as effective as dry land training to blood pressure reduction in postmenopausal hypertensive women. Physiother Res Int. 2014;19:93–8.CrossRefPubMed
27.
go back to reference Boidin M, Lapierre G, Paquette Tanir L, Nigam A, Juneau M, Guilbeault V, et al. Effect of aquatic interval training with Mediterranean diet counseling in obese patients: results of a preliminary study. Ann Phys Rehabil Med. 2015;58:269–75.CrossRefPubMed Boidin M, Lapierre G, Paquette Tanir L, Nigam A, Juneau M, Guilbeault V, et al. Effect of aquatic interval training with Mediterranean diet counseling in obese patients: results of a preliminary study. Ann Phys Rehabil Med. 2015;58:269–75.CrossRefPubMed
28.
go back to reference Delevatti RS, Kanitz AC, Alberton CL, Marson EC, Lisboa SC, Pinho CD, et al. Glucose control can be similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: a randomized clinical trial. J Sci Med Sport. 2015;19:688–93.CrossRefPubMed Delevatti RS, Kanitz AC, Alberton CL, Marson EC, Lisboa SC, Pinho CD, et al. Glucose control can be similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: a randomized clinical trial. J Sci Med Sport. 2015;19:688–93.CrossRefPubMed
29.
go back to reference Farahani AV, Mansournia MA, Asheri H, Fotouhi A, Yunesian M, Jamali M, et al. The effects of a 10-week water aerobic exercise on the resting blood pressure in patients with essential hypertension. Asian J Sports Med. 2010;1:159–67.PubMedPubMedCentral Farahani AV, Mansournia MA, Asheri H, Fotouhi A, Yunesian M, Jamali M, et al. The effects of a 10-week water aerobic exercise on the resting blood pressure in patients with essential hypertension. Asian J Sports Med. 2010;1:159–67.PubMedPubMedCentral
30.
go back to reference Guimarães GV, de Barros Cruz LG, Fernandes-Silva MM, Dorea EL, Bocchi EA. Heated water-based exercise training reduces 24-hour ambulatory blood pressure levels in resistant hypertensive patients: a randomized controlled trial (HEx trial). Int J Cardiol. 2014;172:434–41.CrossRefPubMed Guimarães GV, de Barros Cruz LG, Fernandes-Silva MM, Dorea EL, Bocchi EA. Heated water-based exercise training reduces 24-hour ambulatory blood pressure levels in resistant hypertensive patients: a randomized controlled trial (HEx trial). Int J Cardiol. 2014;172:434–41.CrossRefPubMed
31.
go back to reference Kaddissy G, Lattouf N. Daily integration of the regular aquatic rhythmic activity in women’s life during menopause and its role in the prevention of the metabolic syndrome. Kinesither Rev. 2011;118:48–53. Kaddissy G, Lattouf N. Daily integration of the regular aquatic rhythmic activity in women’s life during menopause and its role in the prevention of the metabolic syndrome. Kinesither Rev. 2011;118:48–53.
32.
go back to reference Kamalakkannan K, Suresh KM. Effect of land and shallow water aerobic exercises on selected physiological and biochemical variables of obese adult. J Phys Educ Sport. 2014;14:532–6. Kamalakkannan K, Suresh KM. Effect of land and shallow water aerobic exercises on selected physiological and biochemical variables of obese adult. J Phys Educ Sport. 2014;14:532–6.
33.
go back to reference Pechter U, Ots M, Mesikepp S, Zilmer K, Kullissaar T, Vihalemm T, et al. Beneficial effects of water-based exercise in patients with chronic kidney disease. Int J Rehabil Res. 2003;26:153–6.CrossRefPubMed Pechter U, Ots M, Mesikepp S, Zilmer K, Kullissaar T, Vihalemm T, et al. Beneficial effects of water-based exercise in patients with chronic kidney disease. Int J Rehabil Res. 2003;26:153–6.CrossRefPubMed
34.
go back to reference Yoo WK, Kim SK, Song MS. Effects of muscular and aqua aerobic combined exercise on metabolic indices in elderly women with metabolic syndrome. J Exerc Nutr Biochem. 2013;17:133–41.CrossRef Yoo WK, Kim SK, Song MS. Effects of muscular and aqua aerobic combined exercise on metabolic indices in elderly women with metabolic syndrome. J Exerc Nutr Biochem. 2013;17:133–41.CrossRef
36.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–12.CrossRefPubMed Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–12.CrossRefPubMed
37.
go back to reference Brixius KS, Schoenberger D, Ladage Knigge H, Falkowski G, Hellmich M, et al. Long-term endurance exercise decreases antiangiogenic endostatin signalling in overweight men aged 50–60 years. Br J Sports Med. 2008;42(2):126–9.CrossRefPubMed Brixius KS, Schoenberger D, Ladage Knigge H, Falkowski G, Hellmich M, et al. Long-term endurance exercise decreases antiangiogenic endostatin signalling in overweight men aged 50–60 years. Br J Sports Med. 2008;42(2):126–9.CrossRefPubMed
38.
go back to reference Gormley SE, Swain DP, High R, Spina RJ, Dowling EA, Kotipalli US, et al. Effect of intensity of aerobic training on VO2max. Med Sci Sports Exerc. 2008;40(7):1336–43.CrossRefPubMed Gormley SE, Swain DP, High R, Spina RJ, Dowling EA, Kotipalli US, et al. Effect of intensity of aerobic training on VO2max. Med Sci Sports Exerc. 2008;40(7):1336–43.CrossRefPubMed
39.
go back to reference Katz J, Wilson BRA. The effects of a six-week, low-intensity nautilus circuit training program on resting blood pressure in females. J Sports Med Phys Fit. 1992;32:299–302. Katz J, Wilson BRA. The effects of a six-week, low-intensity nautilus circuit training program on resting blood pressure in females. J Sports Med Phys Fit. 1992;32:299–302.
40.
go back to reference Elliott KJ, Sale C, Cable NT. Effects of RT and detraining on muscle strength and blood lipid profiles in postmenopausal women. Br J Sports Med. 2002;36:340–4.CrossRefPubMedPubMedCentral Elliott KJ, Sale C, Cable NT. Effects of RT and detraining on muscle strength and blood lipid profiles in postmenopausal women. Br J Sports Med. 2002;36:340–4.CrossRefPubMedPubMedCentral
41.
go back to reference Okamoto T, Masuhara M, Ikuta K. Effects of eccentric and concentric RT on arterial stiffness. J Hum Hypertens. 2006;20:348–54.CrossRefPubMed Okamoto T, Masuhara M, Ikuta K. Effects of eccentric and concentric RT on arterial stiffness. J Hum Hypertens. 2006;20:348–54.CrossRefPubMed
43.
go back to reference Sheldahl LM, Tristani FE, Clifford PS, Kalbfleisch JH, Smits G, Hughes CV. Effect of head-out water immersion on response to exercise training. J Appl Physiol. 1986;60:1878–81.CrossRefPubMed Sheldahl LM, Tristani FE, Clifford PS, Kalbfleisch JH, Smits G, Hughes CV. Effect of head-out water immersion on response to exercise training. J Appl Physiol. 1986;60:1878–81.CrossRefPubMed
44.
go back to reference Takeshima N, Rogers ME, Watanabe E, Brechue WF, Okada A, Yamada T, et al. Water-based exercise improves health-related aspects of fitness in older women. Med Sci Sports Exerc. 2002;34:544–51.CrossRefPubMed Takeshima N, Rogers ME, Watanabe E, Brechue WF, Okada A, Yamada T, et al. Water-based exercise improves health-related aspects of fitness in older women. Med Sci Sports Exerc. 2002;34:544–51.CrossRefPubMed
45.
go back to reference Kanitz AC, Delevatti RS, Reichert T, Liedtke GV, Ferrari R, Almada BP, et al. Effects of two deep water training programs on cardiorespiratory and muscular strength responses in older adults. Exp Gerontol. 2015;64:55–61.CrossRefPubMed Kanitz AC, Delevatti RS, Reichert T, Liedtke GV, Ferrari R, Almada BP, et al. Effects of two deep water training programs on cardiorespiratory and muscular strength responses in older adults. Exp Gerontol. 2015;64:55–61.CrossRefPubMed
46.
go back to reference Frontera WR, Hughes VA, Lutz KJ, Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol. 1991;71:644–50.CrossRefPubMed Frontera WR, Hughes VA, Lutz KJ, Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol. 1991;71:644–50.CrossRefPubMed
47.
go back to reference Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2006;61:1059–64.CrossRefPubMed Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2006;61:1059–64.CrossRefPubMed
48.
go back to reference Manini TM, Clark BC. Dynapenia and aging: an update. J Gerontol A Biol Sci Med Sci. 2012;67(1):28–40.CrossRefPubMed Manini TM, Clark BC. Dynapenia and aging: an update. J Gerontol A Biol Sci Med Sci. 2012;67(1):28–40.CrossRefPubMed
49.
go back to reference Reichert T, Kanitz AC, Delevatti RS, Bagatini NC, Barroso BM, Kruel LF. Continuous and interval training programs using deep water running improves functional fitness and blood pressure in the older adults. Age (Dordr). 2016;38:20.CrossRef Reichert T, Kanitz AC, Delevatti RS, Bagatini NC, Barroso BM, Kruel LF. Continuous and interval training programs using deep water running improves functional fitness and blood pressure in the older adults. Age (Dordr). 2016;38:20.CrossRef
50.
go back to reference Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.CrossRefPubMed Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.CrossRefPubMed
51.
go back to reference Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, et al. Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA. 2002;288:1882–8.CrossRefPubMed Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, et al. Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA. 2002;288:1882–8.CrossRefPubMed
Metadata
Title
Aquatic Training in Upright Position as an Alternative to Improve Blood Pressure in Adults and Elderly: A Systematic Review and Meta-Analysis
Authors
Thaís Reichert
Rochelle Rocha Costa
Bruna Machado Barroso
Vitória de Mello Bones da Rocha
Rodrigo Sudatti Delevatti
Luiz Fernando Martins Kruel
Publication date
01-07-2018
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 7/2018
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-018-0918-0

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