There is a large necessity for met analytic investigation of the blood pressure (BP) response to aquatic exercise training (AET) in hypertensive patients. was to quantify BP changes after (AET) and identify subgroups exhibiting the largest changes. Clinical trials investigating the impact of AET on hypertensive patients published in English and Persian research journals up to July 2020 were searched from google scholar, Pubmed, Science Direct, SID and magiran. Finally, 12 trials were analyzed to quantify effect sizes (difference in means with 95% confidence intervals) using Random Effects model. Subgroup analyses included gender, menopause status, number of sessions per week and training intensity categories. Simple random-effects meta-regression analysis (methods of moment approach) was performed to investigate the association between changes in BP and changes in both training duration and water temperature. AET decreased both SBP and DBP; -12/29 and -5/69 mm Hg respectively, regardless to hypertensive subjects’ characteristics, training session count per week and water temperature. A tendency for larger reductions in SBP with greater reductions in body weight (β1=0.38, P=0.003) and water temperature (β1=1-.29, P=0.012) were observed after AET. In addition, the magnitude of the effect of AET on both SBP and DBP were significant in all subgroups (except for SBP in males) (P <0.05). AET remarkably lowers both SBP and DBP in hypertensive emphasizing on the clinical importance of AET in controlling hypertension. Likewise; it seems more BP reductions could be inevitable in patients with lower body weight and also elevations in water temperature (up to 38 °C). However, more clinical trials still need to be provided because of the lack of evidence and also heterogeneity of the results.
