So, the authors of the two new reviews independently decided to stage their own exercise-versus-drugs scientific rumbles and, for each, use the same, slightly indirect approach. They would, the researchers decided, collect the best recent studies looking at the effectiveness of drugs for a condition and the best comparable studies using exercise to treat the same illness and collate, analyze and compare the various results.

For the first of the new reviews, which was published in December in the British Journal of Sports Medicine, researchers at the London School of Economics, Stanford University and other institutions decided to focus on systolic blood pressure (the top number), in large part because high blood pressure can be so physically devastating, increasing risks for heart disease, Alzheimer’s and early death. Hypertension also is treatable, with drugs that include beta blockers, diuretics and many others, or exercise.

The researchers now gathered 391 randomized, controlled trials — the accepted gold standard for testing treatments — that looked at either a drug or some form of exercise to lower blood pressure. Together, the experiments included almost 50,000 volunteers, with more than 10,000 of them in the exercise studies.

The researchers then summed the data from the drug or exercise tests and found that, in aggregate, all of the drugs and any type of exercise lowered blood pressure, although drugs generally achieved slightly greater reductions. That extra bump downward from drugs may have been a result in part, the researchers believe, to a reliance on relatively healthy volunteers in the exercise studies; their starting blood pressures tended to be lower than in the drug trials, so the drop by the end was slighter.

The methods in the exercise studies also often were less tidy and precise than in the drug tests, the researchers point out. Volunteers in the exercise studies rarely were blinded, for instance, since it’s hard to prevent people from knowing whether or not they are working out. There also was little long-term follow-up of exercisers.