Efficacy of Exercise Interventions for Type 2 Diabetes and Hypertension Co-Morbidity: A Systematic Review Protocol

Background Hypertension and diabetes often occur together, contributing to morbidity and mortality, particularly in environments with limited resources. Inadequate control of hypertension (HTN)-type 2 diabetes (T2DM) is a significant concern in Ghana because of the increasing burden of associated mortality. While medication and traditional therapies remain essential for the management of HTN-T2DM comorbidity, exercise interventions are glaringly lacking. Therefore, this systematic review aims to identify, examine, and synthesise existing evidence regarding the efficacy of exercise interventions for HTN-T2DM comorbidity via an integrated care approach. Methods A systematic review with meta-analysis will be performed. The PubMed, Medline, Cochrane Library, Academic Search Complete, SPORT Discus, and Cumulative Index for Allied Health Literature (CINAHL) databases were systematically searched. Terms related to type 2 diabetes, hypertension, and exercise interventions following the PICO framework. Interventional studies that are randomised and non-randomised controlled trials will be included. Two reviewers will independently screen the studies, extract data via EndNote 22, and assess the quality of the studies and the evidence via the PEDro scale of risk of bias tool and the GRADE approach, respectively. A third reviewer will be consulted to resolve possible conflicts. The analysis will be performed via RevMan (version 5.4; the Cochrane Collaboration). Results This study is currently at the proposal stage and in preparation for the search phase. We aim to start searching peer-reviewed articles in February 2025 and project to complete data extraction in June 2025. Conclusion This systematic review protocol outlines a rigorous methodology for evaluating the effects of exercise interventions for patients with type 2 diabetes and hypertension comorbidity. The findings will inform clinical practice and guide the development of a model of care via an integrated approach. Trial registration CRD420251016833