The potential for positive outcomes was balanced with the risk of adverse events from surgery. There was large variation in the patient values and preferences regarding whether to have the surgery or avoiding surgery and committing to a lifestyle change. Not everyone would or should accept surgery as an intervention due to personal values and the inherent risks of any surgery, including bariatric surgery. The necessary medications and cost of surgery also need to be considered. Most of the evidence focused on patients with comorbid HTN and diabetes. Based on all these considerations, the Work Group determined that there was insufficient evidence for or against recommending bariatric surgery to treat HTN. b. Exercise/Physical Activity Recommendation 18. We suggest offering individual or group-based exercise for the treatment of hypertension to reduce blood pressure. (Weak for | Reviewed, Amended) Discussion The evidence in support of this recommendation was strongest for combined aerobic and resistance exercise interventions and for group/team-based sports. Other interventions reviewed included aerobic dance training, water-based exercise, yoga, traditional Chinese exercises such as Tai Chi and Qigong, and digital interventions to reduce sedentary time. Aerobic and resistance exercise interventions, both individually and in combination, have been shown to reduce blood pressure. Herrod et al. (2018) conducted an SR of RCTs comparing non-pharmacologic strategies to non-intervention controls.[111] The included studies had mean participant ages of at least 65; intervention duration ranged from four weeks to one year. The researchers found statistically significant improvements favoring each type of exercise intervention for both SBP and DBP. MDs in SBP and DBP for combined aerobic/resistance exercise versus control were -5.9 mm Hg and -3.5 mm Hg, respectively. A 2016 meta-analysis by Corso et al. 