Comparative Effects of Four Exercise Management Models on Blood Pressure and BMI in Adults with Prehypertension: A 12-Week Randomized Controlled Trial

Abstract Purpose Physical exercise is widely recognized for its potential to lower hypertension risk in adults with prehypertension. However, evidence remains limited regarding the comparative efficacy of structured exercise management models, especially those that integrate digital monitoring and progressive intensity progression. This randomized controlled trial aimed to compare four distinct exercise management approaches on systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and pulse rate in young and middle-aged adults with high-normal blood pressure. Methods A total of 120 adults (aged 30–50 years) with high‑normal blood pressure (SBP 120–139 mmHg and/or DBP 80–89 mmHg) were randomly allocated to four groups for a 12‑week exercise intervention. Group 1 followed a standard unsupervised exercise prescription. Group 2 adhered to the same prescription but used the “Weidong Manager” platform for real‑time monitoring and reporting. Group 3 followed the same monitored protocol but performed daily aerobic exercise in two 20‑minute sessions. Group 4 combined monitoring with a monthly progressive increase in aerobic intensity from 40% to 60% V̇O₂max. Resting SBP, DBP, BMI, and pulse rate were assessed before and after the intervention. Results All groups showed significant reductions in SBP, DBP, and pulse rate from baseline (all P < 0.05). Between‑group analyses indicated that Group 4 achieved the greatest reductions in both SBP and DBP, while Group 1 showed the smallest improvements. BMI decreased significantly in Groups 2–4 but not in Group 1. Exercise segmentation did not lead to significant differences in any outcome when compared with a single continuous session under equivalent monitoring conditions. Conclusions Exercise management that incorporates digital supervision and gradual intensity progression appears most effective for improving blood pressure and BMI in adults with prehypertension. Segmenting exercise into shorter bouts does not diminish effectiveness, supporting its practical utility for individuals with limited time. These results underline the value of structured, technology‑supported exercise programs in early hypertension prevention.