From Stroke to Strength: The Role of Exercise in Managing Hypertension and Lipid Profiles

Abstract Secondary stroke prevention focuses on managing vascular risk factors such as hypertension, hyperglycemia, and dyslipidemia. However, the impact of exercise training regimens (ETR) on these factors post-stroke remains unclear. We conducted a network meta-analysis (NMA) to compare the effects of different ETR on vascular risk factors and adverse events in patients following stroke or transient ischemic attacks (TIA). We performed a systematic review following PRISMA criteria, searching multiple databases until March 2024. The outcomes of interest included systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total cholesterol (TC), fasting blood glucose (FBG), and body mass index (BMI). A Bayesian network meta-analysis approach was used to estimate mean differences (MD) and 95% credible intervals (CrI). We analyzed 20 randomized clinical trials involving 1653 patients. Moderate intensity continuous training (MICT) and comprehensive training program (CTP) showed the greatest effects on SBP and DBP. Resistance training (RT) was most effective for improving lipid profiles. ETR had no significant effect on post-stroke FBG and BMI. For secondary stroke prevention, MICT and CTP may be beneficial for managing hypertension, while RT could be the primary strategy for improving lipid profiles. Trial Registration: CRD42024554934.