Supervised versus non-supervised exercise intervention for blood pressure reduction in patients with hypertension and prehypertension: a systematic review and meta-analysis.

The non-supervised groups were not equivalent across studies. Some received the same exercise at home, while others received only general physical activity advice, health education, or standard care. Because the control conditions varied, the observed systolic difference may reflect unequal exercise dose, intensity, structure, or support rather than supervision alone. The pooled systolic and diastolic results had high heterogeneity, so the average effect should not be read as a stable single estimate. Only 10 studies were pooled, and the subgroup analyses were small, especially for isometric handgrip and combined training. Many participants were taking antihypertensive medication, and some studies did not report medication status, which may have limited additional blood pressure reduction. One included study had poor methodological quality, and the overall PEDro scores ranged from fair to good rather than excellent. Supervision was defined only by the proportion of supervised sessions, which may not capture the type, frequency, or quality of supervision.

No funding was declared, and the authors declared no potential conflicts of interest.

Do not conclude that supervision alone caused the 3.46 mmHg systolic difference. Some non-supervised groups received general advice, health education, or different exercise programs, and some interventions included hypocaloric diet or antihypertensive medication.