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The Role of Exercise Training in the Treatment of Hypertension

An Update

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Abstract

Hypertension is a very prevalent cardiovascular (CV) disease risk factor in developed countries. All current treatment guidelines emphasise the role of nonpharmacological interventions, including physical activity, in the treatment of hypertension. Since our most recent review of the effects of exercise training on patients with hypertension, 15 studies have been published in the English literature. These results continue to indicate that exercise training decreases blood pressure (BP) in approximately 75% of individuals with hypertension, with systolic and diastolic BP reductions averaging approximately 11 and 8mm Hg, respectively. Women may reduce BP more with exercise training than men, and middle-aged people with hypertension may obtain greater benefits than young or older people. Low to moderate intensity training appears to be as, if not more, beneficial as higher intensity training for reducing BP in individuals with hypertension. BP reductions are rapidly evident although, at least for systolic BP, there is a tendency for greater reductions with more prolonged training. However, sustained BP reductions are evident during the 24 hours following a single bout of exercise in patients with hypertension.

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References

  1. Brown M, Hagberg J. Does exercise training play a role in the treatment of essential hypertension? J Cardiovasc Risk 1995; 2: 296–302

    Article  PubMed  Google Scholar 

  2. Dengel DR, Hagberg JM, Pratley RE, et al. Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men. Metabolism 1998; 47: 1075–82

    Article  PubMed  CAS  Google Scholar 

  3. Motoyama M, Sunami Y, Kinoshita F, et al. Blood pressure lowering effect of low intensity aerobic training in elderly hypertensive patients. Med Sci Sports Exerc 1998; 30: 818–23

    Article  PubMed  CAS  Google Scholar 

  4. Kohno K, Matsuoka H, Takenaka K, et al. Renal depressor mechanisms of physical training in patients with essential hypertension. Am J Hypertens 1997; 10: 859–68

    Article  PubMed  CAS  Google Scholar 

  5. Tanaka H, Bassett Jr DR, Howley ET, et al. Swimming training lowers the resting blood pressure in individuals with hypertension. J Hypertens 1997; 15: 651–7

    Article  PubMed  CAS  Google Scholar 

  6. Ishikawa K, Ohta T, Zhang J, et al. Influence of age and gender on exercise training-induced blood pressure reduction in systemic hypertension. Am J Cardiol 1999; 84: 192–6

    Article  PubMed  CAS  Google Scholar 

  7. Dengel DR, Galecki AT, Hagberg JM, et al. The independent and combined effects of weight loss and aerobic exercise on blood pressure and oral glucose tolerance in older men. Am J Hypertens 1998; 11: 1405–12

    Article  PubMed  CAS  Google Scholar 

  8. Higashi Y, Sasaki N, Nakagawa K, et al. Daily aerobic exercise improves reactive hyperemia in patients with essential hypertension. Hypertension 1999; 33: 591–7

    Article  PubMed  CAS  Google Scholar 

  9. Moreira WD, Fuchs FD, Ribeiro JP, et al. The effects of two aerobic training intensities on ambulatory blood pressure in hypertensive patients: results of a randomized trial. J Clin Epidemiol 1999; 52: 637–42

    Article  PubMed  CAS  Google Scholar 

  10. Kokkinos P, Narayan P, Colleran J, et al. Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension. N Engl J Med 1995; 333: 1462–7

    Article  PubMed  CAS  Google Scholar 

  11. Ketelhut RG, Franz IW, Scholze J. Efficacy and position of endurance training as a non-drug therapy in the treatment of arterial hypertension. J Hum Hypertens 1997; 11: 651–5

    Article  PubMed  CAS  Google Scholar 

  12. Fish AF, Smith BA, Frid DJ, et al. Step treadmill exercise training and blood pressure reduction in women with mild hypertension. Cardiovasc Nurs 1997; 12: 4–12

    CAS  Google Scholar 

  13. Zanettini R, Bettega D, Agostoni O, et al. Exercise training in mild hypertension: effects on blood pressure, left ventricular mass and coagulation factor VII and fibrinogen. Cardiology 1997; 88: 468–73

    Article  PubMed  CAS  Google Scholar 

  14. Nho H, Tanaka K, Watanabe H, et al. Exercise training in female patients with a family history of hypertension. Eur J Appl Physiol 1998; 78: 1–6

    Article  CAS  Google Scholar 

  15. Gordon N, Scott C, Levine B. Comparison of single versus multiple lifestyle interventions: are the antihypertensive effects of exercise training and diet-induced weight loss additive? Am J Cardiol 1997; 79: 763–7

    Article  PubMed  CAS  Google Scholar 

  16. Akinpelu A. Responses of the African hypertensive to exercise training: preliminary observations. J Hum Hypertens 1990; 4: 74–6

    PubMed  CAS  Google Scholar 

  17. Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Sixth report of the Joint National Committee. Washington, DC: National Institutes of Health, 1997

    Google Scholar 

  18. Hagberg J, Blair S, Ehsani A, et al. Position stand: physical activity, physical fitness, and hypertension. Med Sci Sports Exerc 1993; 25: i–x

    Google Scholar 

  19. Kaplan N. Clinical hypertension. 5th ed. Baltimore (MD): Williams & Wilkins, 1990

    Google Scholar 

  20. Tipton C, Matthes R, Marcus K, et al. Influences of exercise intensity, age, and medication on resting blood pressure in SHR populations. J Appl Physiol 1983; 55: 1305–10

    PubMed  CAS  Google Scholar 

  21. Fitzgerald W. Labile hypertension and jogging: new diagnostic tool or spurious discovery? BMJ 1981; 282: 542–4

    Article  PubMed  CAS  Google Scholar 

  22. Kenny MJ, Seals DR. Postexercise hypotension: key features, mechanisms, and clinical significance. Hypertension 1993; 22: 653–64

    Article  Google Scholar 

  23. Hagberg J, Montain S, Martin W. Blood pressure and hemodynamic responses following exercise in older hypertensives. J Appl Physiol 1987; 63: 270–6

    PubMed  CAS  Google Scholar 

  24. Brownley KA, West SG, Hinderliter AL, et al. Acute aerobic exercise reduces ambulatory blood pressure in borderline hypertensive men and women. Am J Hypertens 1996; 9: 200–6

    Article  PubMed  CAS  Google Scholar 

  25. Taylor-Tolbert N, Dengel D, Brown M, et al. Ambulatory blood pressure after acute exercise in older men with essential hypertension. Am J Hypertens 2000; 13 (1 Pt 1): 44–51

    Article  PubMed  CAS  Google Scholar 

  26. Zee RYL, Lou YK, Lyn R, et al. Association of a polymorphism of the angiotensin I-converting enzyme gene with essential hypertension. Biochem Biophys Res Comm 1992; 184: 9–15

    Article  PubMed  CAS  Google Scholar 

  27. Turner ST, Boerwinkle E, Sing CF. Context-dependent associations of the ACE I/D polymorphism with blood pressure. Hypertension 1999; 34: 773–8

    Article  PubMed  CAS  Google Scholar 

  28. O’Donnell CJ, Lindpaintner K, Larson MG, et al. Evidence for association and genetic linkage of the angiotensin-converting enzyme locus with hypertension and blood pressure in men but not women in the Framingham Heart Study. Circulation 1998; 97: 1766–72

    Article  PubMed  Google Scholar 

  29. Jeunemaitre X, Soubrier F, Kotelevtsev Y. Molecular basis of human hypertension: role of angiotensinogen. Cell 1992; 71: 169–80

    Article  PubMed  CAS  Google Scholar 

  30. Kunz R, Kreutz R, Beige J, et al. Association between the angiotensinogen 235T-variant and essential hypertension in whites. Hypertension 1997; 30: 1331–7

    Article  PubMed  CAS  Google Scholar 

  31. Staessen JA, Kuznetsova T, Wang JG, et al. M235T angiotensinogen gene polymorphism and cardiovascular renal risk. J Hypertens 1999; 17: 9–17

    Article  PubMed  CAS  Google Scholar 

  32. Hagberg JM, Ferrell RE, Dengel DR, et al. Exercise training-induced blood pressure and plasma lipid improvements in hypertensives may be genotype dependent. Hypertension 1999; 34: 18–23

    Article  PubMed  CAS  Google Scholar 

  33. Brown M, Moore G, Korytkowski M, et al. Improvement of insulin sensitivity by short-termexercise training in hypertensive African American women. Hypertension 1997; 30: 1549–53

    Article  PubMed  CAS  Google Scholar 

  34. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Fifth report of the Joint National Committee. Arch Intern Med 1988; 148: 1023–38

    Article  Google Scholar 

  35. Wood P, Stefanick M. Exercise, fitness, and atherosclerosis. In: Bouchard C, Shephard RJ, Stephens T, et al., editors. Exercise, fitness, and health. Champaign (IL): Human Kinetics, 1990: 409–23

    Google Scholar 

  36. Tanabe Y, Sasaki J, Urata H, et al. Effect of mild aerobic exercise on lipid and apolipoprotein levels in patients with essential hypertension. Jpn Heart J 1988; 29: 199–206

    Article  PubMed  CAS  Google Scholar 

  37. Bonnano J, Lies J. Effects of physical training on coronary risk factors. Am J Cardiol 1974; 33: 760–3

    Article  Google Scholar 

  38. Kelemen M, Effron M, Valenti S, et al. Exercise training combined with antihypertensive drug therapy. JAMA 1990; 263: 2766–71

    Article  PubMed  CAS  Google Scholar 

  39. Sasaki J, Urata H, Tanabe Y, et al. Mild exercise therapy increases serum high density lipoprotein2 cholesterol levels in patients with essential hypertension. Am J Med Sci 1989; 297: 220–3

    Article  PubMed  CAS  Google Scholar 

  40. Dubbert PM, Martin JE, Cushman WC, et al. Endurance exercise in mild hypertension: effects on blood pressure and associated metabolic and quality of life variables. J Hum Hypertens 1994; 8: 265–72

    PubMed  CAS  Google Scholar 

  41. Dengel D, Pratley R, Hagberg J, et al. Impaired insulin sensitivity and maximal responsiveness in older hypertensive men. Hypertension 1994; 23: 320–4

    Article  PubMed  CAS  Google Scholar 

  42. Ferraninni E, Buzzigoli G, Bonadonna R, et al. Insulin resistance in essential hypertension. N Engl J Med 1987; 317: 350–7

    Article  Google Scholar 

  43. Hagberg J, Montain S, Martin W, et al. Effect of exercise training on 60 to 69 year old persons with essential hypertension. Am J Cardiol 1989; 64: 348–53

    Article  PubMed  CAS  Google Scholar 

  44. Bursztyn M, Ben-Ishay D, Shochina M, et al. Disparate effects of exercise training on glucose tolerance and insulin levels and on ambulatory blood pressure in hypertensive patients. Hypertension 1983; 11: 1121–5

    Google Scholar 

  45. Baglivo H, Fabregues H, Burrieza RC, et al. Effect of moderate physical training on left ventricular mass in mild hypertensive persons. Hypertension 1990; 15: 1153–6

    Article  Google Scholar 

  46. Koren MJ, Devereux RB. Mechanism, effects, and reversal of left ventricular hypertrophy in hypertension. Curr Opin Nephrol Hypertens 1993; 2 (1): 87–95

    Article  Google Scholar 

  47. Koren MJ, Devereux RB, Casale PN, et al. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991; 114: 345–52

    PubMed  CAS  Google Scholar 

  48. Anderson KM, Wilson W, Odell PM, et al. An updated coronary risk profile. Circulation 1997; 83: 356–62

    Article  Google Scholar 

  49. Holloszy J, Schultz J, Kusnierkiewicz J, et al. Effects of exercise on glucose tolerance and insulin resistance: brief review and some preliminary results. Acta Med Scand 1986; 711: 55–65

    CAS  Google Scholar 

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Hagberg, J.M., Park, JJ. & Brown, M.D. The Role of Exercise Training in the Treatment of Hypertension. Sports Med 30, 193–206 (2000). https://doi.org/10.2165/00007256-200030030-00004

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