# Effects of Aquatic Exercise on Individuals with Hypertension: A Systematic Review

## TL;DR

This paper reviews how water-based exercise affects blood pressure in people with hypertension, finding potential benefits but noting study limitations.

## Contribution

The study provides an updated systematic review on aquatic exercise effects for hypertension, highlighting methodological limitations.

## Key findings

- Aquatic exercise is associated with blood pressure reductions in hypertensive individuals.
- Common interventions include water walking and strength exercises, but not swimming.
- Most studies had a moderate to high risk of bias, limiting conclusion strength.

## Abstract

Introduction: Exercise has proven to be an excellent tool for improving health in individuals with hypertension. A particularly interesting environment for performing exercise is the aquatic medium, whose unique properties have shown effectiveness in reducing blood pressure values. Objective: Our objective was to provide an update on the available scientific evidence regarding the effects of aquatic exercise on individuals with hypertension. Methods: A systematic search was conducted in the databases PubMed, Web of Science, CINAHL, Sport Discus, Medline, Scopus, and PEDro. Methodological quality was assessed using the PEDro scale, and the risk of bias was evaluated using the RoB 2 tool. Results: Eleven studies were included, with a total of 402 participants, obtaining a mean score of 5.7 on the PEDro scale. Five studies presented a high risk of bias, four showed a low risk, and in two, the risk was unclear. The most used therapeutic exercises in the analyzed interventions were water walking, aquatic mobility and strength exercises, aquatic high-intensity interval training, and aquatic calisthenics. Notably, none of the interventions included swimming. Conclusions: Aquatic exercise appears to be associated with reductions in blood pressure in individuals with hypertension; however, these findings should be interpreted cautiously due to the methodological limitations and heterogeneity of the included studies.