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(Hypertension. 2000;36:171.)
© 2000 American Heart Association, Inc.

Scientific Contributions

Effects of Exercise and Weight Loss on Mental Stress–Induced Cardiovascular Responses in Individuals With High Blood Pressure

Anastasia Georgiades; Andrew Sherwood; Elizabeth C. D. Gullette; Michael A. Babyak; Alan Hinderliter; Robert Waugh; Damon Tweedy; Linda Craighead; Richard Bloomer; James A. Blumenthal

From the Department of Psychiatry and Behavioral Science (A.G., A.S., E.C.D.G., M.A.B., D.T., R.B., J.A.B.) and the Department of Medicine (R.W.), Duke University Medical Center, Durham, NC; the Department of Medicine (A.H.), University of North Carolina, Chapel Hill; and the Department of Psychology (L.C.), University of Colorado, Boulder.

Correspondence to Anastasia Georgiades, PhD, Department of Psychiatry and Behavioral Science, Box 3119, Duke University Medical Center, Durham, NC 27710.

Abstract—The purpose of this study was to determine the effects of exercise and weight loss on cardiovascular responses during mental stress in mildly to moderately overweight patients with elevated blood pressure. Ninety-nine men and women with high normal or unmedicated stage 1 to stage 2 hypertension (systolic blood pressure 130 to 179 mm Hg, diastolic blood pressure 85 to 109 mm Hg) underwent a battery of mental stress tests, including simulated public speaking, anger recall interview, mirror trace, and cold pressor, before and after a 6-month treatment program. Subjects were randomly assigned to 1 of 3 treatments: (1) aerobic exercise, (2) weight management combining aerobic exercise with a behavioral weight loss program, or (3) waiting list control group. After 6 months, compared with control subjects, participants in both active treatment groups had lower levels of systolic blood pressure, diastolic blood pressure, total peripheral resistance, and heart rate at rest and during mental stress. Compared with subjects in the control group, subjects in the exercise and weight management groups also had greater resting stroke volume and cardiac output. Diastolic blood pressure was lower for the weight management group than for the exercise-only group during all mental stress tasks. These results demonstrate that exercise, particularly when combined with a weight loss program, can lower both resting and stress-induced blood pressure levels and produce a favorable hemodynamic pattern resembling that targeted for antihypertensive therapy.

Key Words: hypertension, essential • exercise • obesity • stress • hemodynamics

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