Background: Uncertainty persists regarding the dose–response association between exercise exposure and blood pressure (BP) control in chronic kidney disease (CKD). This dose–response network meta-analysis examined whether different exercise modalities and model-estimated metabolic-equivalent exposure levels were associated with changes in systolic BP (SBP) and diastolic BP (DBP). Methods: Exercise dose was estimated as metabolic equivalents of task minutes per week (MET-min/week) from reported session duration, frequency, and intensity. Primary outcomes were changes in SBP and DBP, with exploratory subgroup analyses by dialysis status, baseline BP, and intervention duration. Results: The analysis included 26 randomized controlled trials (1218 participants). Aerobic exercise was associated with lower SBP, with the greatest model-estimated reduction at 880 MET-min/week (MD, −7.73 mm Hg). Resistance and mind–body exercise also showed model-estimated reductions, whereas combined aerobic-resistance training was not statistically significant. Dose–response estimates differed by dialysis status and intervention length, but several subgroup estimates were based on sparse data and wide uncertainty. Evidence certainty ranged from very low to high (CINeMA). Conclusions: Exercise interventions may be associated with BP reduction in CKD, but the identified MET-min/week ranges should be interpreted as exploratory, model-derived estimates rather than validated therapeutic thresholds. Better reported randomized trials are needed to confirm dose ranges, safety, adherence, and tolerability in dialysis and non-dialysis CKD populations.

Objective: This study assessed the blood-pressure effects of various exercise regimens in middle-aged and older adults with type 2 diabetes, considering baseline levels, to clarify dose–response relationships for personalized exercise guidance. Methods: We conducted a dose–response network meta-analysis. Systematic searches were performed in Web of Science, EMBASE, PubMed and Cochrane Library. Baseline blood pressure was modelled as an explanatory variable via meta-regression. Thirty-six eligible RCTs of physical-activity interventions in older adults with type 2 diabetes reporting blood-pressure outcomes were included. Results: In stage 1–2 hypertension, mind–body activities were associated with the greatest systolic blood-pressure reduction and appear to be the most effective intervention based on available evidence. For diastolic blood pressure, combined aerobic-resistance training was effective in stage 1 hypertension. Dose–response analysis indicated that clinically meaningful reductions occur at modest volumes (668 and 657 MET-min/week for systolic and diastolic pressures, respectively), aligning with the lower end of international activity guidelines. Conclusions: Individualized exercise prescription based on baseline blood pressure may offer a useful non-pharmacological strategy for hypertension management in older adults with type 2 diabetes. By quantifying the required activity dose, this work provides an evidence base for integrating structured exercise into precision care for this high-risk population.

Background: Maximal oxygen uptake (VO ₂ max) is a critical determinant of endurance performance in athletes, yet the comparative effectiveness and dose-response profiles of different supplementary exercise training modalities remain incompletely characterized. This systematic review and Bayesian network meta-analysis aimed to compare 11 exercise training modalities for improving VO ₂ max in healthy athletes, examine dose-response relationships, explore effect modification by sport type, and evaluate study-level moderators using network meta-regression. Methods: Four databases were searched for randomized controlled trials. Bayesian network meta-analysis (NMA), Bayesian network meta-regression, and dose-response NMA were conducted. Confidence in the evidence was assessed using the Confidence in Network Meta-Analysis framework. Results: Sixty-one studies were included in the systematic review; 60 contributed to the main NMA and 31 to the dose-response NMA. Five exercise modalities were significantly superior to the active control condition, which consisted of maintaining regular sport-specific training without additional supplementary intervention: blood flow restriction training, high-intensity interval training (HIIT), intermittent hypoxic training, sprint interval training (SIT), and small-sided games (SSG). HIIT and SIT showed the most consistent overall support, although sparse subgroup findings remained exploratory. The dose-response analysis suggested that the modelled significant regions extended across the observed supplementary exercise dose ranges for HIIT, SIT, and SSG. Bayesian network meta-regression showed no clear effect modification by age, baseline VO ₂ max, or intervention duration. Conclusions: Given the predominantly low to very low certainty of evidence, the findings should be interpreted cautiously. HIIT and SIT appeared to be the most consistently supported supplementary modalities for improving VO ₂ max in trained athletes, but these model-based findings require confirmation in larger, higher-quality head-to-head trials with common active control groups and standardized VO ₂ max methodology. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261360986 , identifier CRD420261360986.