Obesity-related hypertension (ORH) , as a long-term persistent chronic disease, is growing in prevalence in China. Exercise is an important means of prevention and treatment for ORH, but due to the limitations of space, distance and cost in exercise rehabilitation, exercise completion and compliance are mostly difficult to ensure, and the health benefits of exercise are greatly reduced. Therefore, it is important to explore appropriate exercise prescription and management models.

To evaluate the clinical efficacy and safety of five-body balance exercise based on the "hospital-gym-community" model for patients with ORH.

This was a prospective randomised controlled study. 84 ORH patients recruited at Guang'anmen Hospital, China Academy of Traditional Chinese Medicine from June 2022 to December 2023 were selected and randomly divided into the experimental group (n=42) and the control group (n=42) by using the SPSS 26.0 online random number generator. Subjects in both groups received the same lifestyle intervention. The control group was provided with moderate-intensity aerobic exercise, and the experimental group was provided with the five-body balance exercise training based on the "hospital-gym-community" rehabilitation model for a period of 6 months. Systolic blood pressure (SBP) , diastolic blood pressure (DBP) , mean arterial pressure (MAP) , waist circumference (WC) , body weight (BW) , BMI, hip circumference (HC) , waist-to-hip ratio (WHR) , waist-to-height ratio (WHtR) , fasting blood glucose (GLU) , total cholesterol (TC) , low-density lipoprotein cholesterol (LDL-C) , very low-density lipoprotein cholesterol (VLDL-C) , triglycerides (TG) , serum ceramides (Cer) , Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) , Short-form Health Survey-36 (SF-36) , and Pittsburgh Sleep Quality Index (PSQI) were observed before and after the intervention in the two groups of subjects. The major adverse cardiovascular events (MACE) and exercise injuries that occurred during the intervention were also recorded.

Eventually 37 subjects in the experimental group and 36 subjects in the control group completed the trial. After 6 months of rehabilitation, SBP, DBP, MAP, WC, BW, BMI, HC, WHR, WHtR, LDL-C, Cer, SAS, SDS, and PSQI in the experimental group were lower than those in the control group (P<0.05) , SF-36 was higher than that in the control group (P<0.05) , and there was no statistically significant difference between GLU, TC, VLDL-C, TG in the experimental group and the control group (P>0.05) . After intervention, SBP, DBP, MAP, WC, BW, BMI, HC, WHR, WHtR, GLU, LDL-C, VLDL-C, TG, Cer, SAS, SDS, and PSQI were lower than before the intervention in the experimental group (P<0.05) , SF-36 was higher compared to the pre-intervention in the experimental group (P<0.05) , and the difference in TC before and after the intervention was not statistically significant (P>0.05) . There were no MACE or exercise injuries in both groups.

The five-body balance exercise based on the "hospital-gym-community" rehabilitation model can promote the blood pressure and morphological indexes of patients with ORH, improve the quality of life, and its efficacy is better than the conventional aerobic exercise, with good safety. It also reduces serum Cer levels, reflecting to some extent the potentially beneficial effects of the exercise programme in reducing cardiovascular risk.