A study published in the Journal of Human Hypertension reveals that Pilates training programs are safe for patients with hypertension and that these programs can be incorporated as a part of their rehabilitation.
Study: The efficacy of Pilates method in patients with hypertension: systematic review and meta-analysis. Image Credit: ESB Professional / Shutterstock
Background
Hypertension or high blood pressure is a major public health concern because of its widespread prevalence. The condition significantly increases the risk of cardiovascular disease and associated disability and mortality. Although medicines can effectively treat hypertension, consistent treatment adherence is the primary requisite for optimal outcomes.
Available evidence indicates that a combination of pharmacological and non-pharmacological interventions is highly effective in managing all risk factors associated with hypertension. In particular, physical exercise is considered to be an excellent intervention to reduce blood pressure in hypertensive patients. This intervention effectively reduces blood pressure even in patients who are low responsive to anti-hypertension medications.
Among various types of physical activities, aerobic exercise is considered the primary option for managing blood pressure. In addition, isometric exercise, dynamic resistance exercise, and high-intensity interval training have shown positive effects in hypertensive patients. However, despite many health benefits, these physical activities are generally associated with a low adherence rate.
In this systematic review and meta-analysis, scientists have explored the effectiveness of Pilates training programs in managing blood pressure in hypertensive patients. They have considered Pilates an alternative physical exercise option because of its adaptability in various conditions, such as rehabilitation and fitness.
Study design
The scientists searched across four electronic databases for randomized clinical trials and comparative studies that investigated the effect of Pilates training on blood pressure in patients with hypertension.
A total of four randomized clinical trials and seven comparative studies were included in the final analysis. All these studies were published between 2015 and 2023. Regarding the methodological quality of selected studies, one was low quality, four were good quality, and six were high quality.
The selected studies included a total of 458 participants with decompensated hypertension, arterial hypertension, or normal tension. All arterial hypertensive participants received anti-hypertensive treatment during the Pilates training.
Nine out of eleven selected studies used Pilates-based Mat as their study intervention; one used Pilates with apparatus, and one used both. In comparative studies, the control groups performed aerobic exercises or daily life activities.
Important observations
A considerable proportion of selected studies described the positive impacts of Pilates training programs in managing blood pressure in hypertensive patients. Data from three randomized controlled trials and two comparative studies was included in the meta-analysis.
The findings revealed that Pilates has significantly higher potency in reducing systolic, diastolic, and mean blood pressure compared to other physical activity interventions employed in control groups.
The meta-analysis of data from four comparative studies indicated that Pilates exerts similar blood pressure-lowering effects in hypertensive and normotensive participants. However, these effects were not statistically significant.
Study significance
The meta-analysis finds that Pilates is safe and effective for managing blood pressure in hypertensive patients. However, it might not necessarily have superior effects compared to other physical exercise interventions.
Most studies included in the systematic review and meta-analysis highlight the significant positive effects of Mat Pilates on blood pressure. This suggests that the incorporation of exercises that require isometric strength could be helpful in lowering blood pressure.
Mat Pilates is a low-to-moderate-intensity exercise. In contrast, Pilates with apparatus is a high-intensity exercise. Studies that employed Pilates with apparatus could not find any significant blood pressure-lowering effects. This indicates that the intensity of Pilates is an important factor to consider while applying this intervention for blood pressure management. In support of this hypothesis, existing literature depicts that light or moderate aerobic exercise is more effective than high-intensity aerobic exercise in reducing blood pressure.
Although the findings of the meta-analysis indicated blood pressure-lowering effects of Pilates, overall, it was found that Pilates does not have greater effects than aerobic exercises. Moreover, a combination of aerobic exercise and Pilates failed to demonstrate greater benefits.
Based on these observations, scientists advise incorporating Pilates as a part of the rehabilitation approach to manage blood pressure in hypertensive patients. However, it should be noted that Pilates may not necessarily offer greater benefits than aerobic exercises and that it may not necessarily help improve adherence to training programs.
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