Effect of exercise training on the renin-angiotensin-aldosterone system: a meta-analysis

source extracted confidence: high 2026-04-09
#humans #renin-angiotensin-system #renin #aldosterone #blood-pressure

Effect of exercise training on the renin-angiotensin-aldosterone system: a meta-analysis

Baffour-Awuah et al., 2024 | J Hum Hypertens | Meta Analysis

Citation

Baffour-Awuah Biggie, Man Melody, ... Pearson Melissa J. Effect of exercise training on the renin-angiotensin-aldosterone system: a meta-analysis. J Hum Hypertens. 2024-Feb;38(2):89-101. doi:10.1038/s41371-023-00872-4

Abstract

Blood pressure (BP) management reduces the risk of cardiovascular disease (CVD). The renin-angiotensin-aldosterone system (RAAS) plays an important role in regulating and maintaining blood volume and pressure. This analysis aimed to investigate the effect of exercise training on plasma renin, angiotensin-II and aldosterone, epinephrine, norepinephrine, urinary sodium and potassium, BP and heart rate (HR). We systematically searched PubMed, Web of Science, and the Cochrane Library of Controlled Trials until 30 November 2022. The search strategy included RAAS key words in combination with exercise training terms and medical subject headings. Manual searching of reference lists from systematic reviews and eligible studies completed the search. A random effects meta-analysis model was used. Eighteen trials with a total of 803 participants were included. After exercise training, plasma angiotensin-II (SMD -0.71; 95% CI -1.24, -0.19; p = 0.008; n = 9 trials), aldosterone (SMD -0.37; 95% CI -0.65, -0.09; p = 0.009; n = 8 trials) and norepinephrine (SMD -0.82; 95% CI -1.18, -0.46; p < 0.001; n = 8 trials) were reduced. However, plasma renin activity, epinephrine, and 24-h urinary sodium and potassium excretion remained unchanged with exercise training. Systolic BP was reduced (MD -6.2 mmHg; 95% CI -9.9, -2.6; p = 0.001) as was diastolic BP (MD -4.5 mmHg; 95% CI -6.9, -2.1; p < 0.001) but not HR (MD -3.0 bpm; 95% CI -6.0, 0.4; p = 0.053). Exercise training may reduce some aspects of RAAS and sympathetic nervous system activity, and this explains some of the anti-hypertensive response.

Key Findings

Exercise training may reduce some aspects of RAAS and sympathetic nervous system activity, and this explains some of the anti-hypertensive response.

Outcomes Measured

  • blood pressure
  • systolic blood pressure
  • diastolic blood pressure

Population

Field Value
Population See abstract
Sample Size 9
Age Range See abstract
Condition blood pressure

MeSH Terms

  • Humans
  • Renin-Angiotensin System
  • Renin
  • Aldosterone
  • Blood Pressure
  • Norepinephrine
  • Epinephrine
  • Angiotensin II
  • Potassium
  • Sodium
  • Exercise

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Systematic Review, Meta-Analysis, Journal Article
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09