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 < 0.001; n = 8 trials) were reduced. However, plasma renin activity, epinephrine, and 24-h urinary sodium and potassium excretion remained unchanged with exercise training. Systolic BP was reduced (MD −6.2 mmHg; 95% CI −9.9, −2.6; p = 0.001) as was diastolic BP (MD −4.5 mmHg; 95% CI −6.9, −2.1; p < 0.001) but not HR (MD −3.0 bpm; 95% CI −6.0, 0.4; p = 0.053). Exercise training may reduce some aspects of RAAS and sympathetic nervous system activity, and this explains some of the anti-hypertensive response.

血压 (BP) 管理可降低心血管疾病 (CVD) 的风险。肾素-血管紧张素-醛固酮系统（RAAS）在调节和维持血容量和血压方面发挥着重要作用。本分析旨在探讨运动训练对血浆肾素、血管紧张素-II 和醛固酮、肾上腺素、去甲肾上腺素、尿钠和尿钾、血压和心率 (HR) 的影响。截至 2022 年 11 月 30 日，我们系统地检索了 PubMed、Web of Science 和 Cochrane 对照试验图书馆。检索策略包括 RAAS 关键词与运动训练术语和医学主题标题的结合。从系统评价和合格研究中手动搜索参考文献列表完成了搜索。使用随机效应荟萃分析模型。共纳入 18 项试验，共有 803 名参与者。运动训练后，血浆血管紧张素-II（SMD -0.71；95% CI -1.24，-0.19；p  = 0.008；n  = 9 项试验）、醛固酮（SMD -0.37；95% CI -0.65，-0.09；p  = 0.009） ；n  = 8 项试验）和去甲肾上腺素（SMD -0.82；95% CI -1.18，-0.46；p  < 0.001；n  = 8 项试验）减少。然而，血浆肾素活性、肾上腺素以及24小时尿钠和钾排泄量在运动训练后保持不变。收缩压降低（MD -6.2 mmHg；95% CI -9.9, -2.6；p  = 0.001），舒张压也降低（MD -4.5 mmHg；95% CI -6.9, -2.1；p  < 0.001），但 HR 没有降低（ MD -3.0 bpm；95% CI -6.0，0.4；p  = 0.053）。运动训练可能会减少 RAAS 和交感神经系统某些方面的活动，这解释了一些抗高血压反应。