OBJECTIVES: To meta-analyze candidate gene association studies on the change in blood pressure beyond the immediate post-exercise phase after versus before aerobic exercise. DESIGN: Meta-analysis. METHODS: A systematic search was conducted. Studies retrieved included acute (short-term or postexercise hypotension) or chronic (long-term or training) aerobic exercise interventions; and blood pressure measured before and after aerobic exercise training, or before and after exercise or control under ambulatory conditions by genotype. Effect sizes were determined for genotype and adjusted for sample features. RESULTS: Qualifying studies (k = 17, n = 3524) on average included middle-aged, overweight men (44.2%) and women (55.8%) with prehypertension (134.9 +/- 11.7/78.6 +/- 9.5 mmHg). Training interventions (k = 12) were performed at 60.4 +/- 12.9% of maximum oxygen consumption (VO2max) for 41.9 +/- 12.5 min session-1, 3.6 +/- 1.2 days/week for 15.7 +/- 7.6 week; and post-exercise hypotension interventions (k = 5) were performed at 53.5 +/- 14.4% VO2maxfor 38.5 +/- 5.4 min session-1. Sample characteristics explained 54.2 to 59.0% of the variability in the blood pressure change after versus before acute exercise or control under ambulatory conditions, and 57.4 to 67.1% of the variability in the blood pressure change after versus before training (p < 0.001). Only angiotensinogen M235T (rs699) associated with the change in diastolic blood pressure after versus before training (R2 = 0.1%, p = 0.05), but this association did not remain statistically significant after adjustment for multiple comparisons. CONCLUSIONS: Sample characteristics explained most of the variability in the change of BP beyond the immediate post-exercise phase after versus before acute and chronic aerobic exercise. Angiotensinogen M235T (rs699) was the only genetic variant that associated with the change in diastolic blood pressure after versus before training, accounting for < 1% of the variance.

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