Hypertension, Vol 7, 125-131, Copyright © 1985 by American Heart Association
A Kiyonaga, K Arakawa, H Tanaka and M Shindo
Twelve patients with essential hypertension (WHO stages I-II) were
subjected to mild aerobic exercise for 10 to 20 weeks. The time course of
changes in the resting blood pressure and multiple hormonal responses
(plasma catecholamines, prostaglandin E, renin-angiotensin system,
kallikrein-bradykinin system) were monitored. Depressor response of both
systolic and diastolic pressures was seen, and after 5 weeks of exercise
blood pressure stabilized at a significantly lower level. Adjustment of
work load in response to increased physical fitness at the 10th week
produced further reduction of blood pressure especially in diastole. After
exercise therapy we found significant reductions in plasma catecholamine
levels, and increases in levels of plasma prostaglandin E and the urinary
excretion of sodium. A reduction in systolic/diastolic (mean) pressures by
more than 20/10 (13) mm Hg was seen in 50% of patients after 10 weeks and
in 78% after 20 weeks of exercise. Those who achieved effective blood
pressure fall after 10 weeks of training (n = 6) were compared with the
rest (n = 6). This analysis revealed that the initial value of plasma renin
activity of the former was significantly lower than that of the latter.
Significant negative correlations (r = -0.78) also were observed between
the blood pressure reduction and corresponding initial value of plasma
renin activity. These results indicate that exercise therapy is a potent
nonpharmacological tool for the treatment of essential hypertension,
especially of the low renin type. Both diminished sympathoadrenergic
activity and enhancement of prostaglandin mechanisms might be responsible
for the falls in arterial pressure.
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