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

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