Published online before print July 2, 2007, doi: 10.1161/HYPERTENSIONAHA.107.087718
(Hypertension. 2007;50:294.)
© 2007 American Heart Association, Inc.
Editorial Commentaries |
Exercise as a Physiologic Intervention to Counteract Hypertension
Can a Good Idea Go Bad?
From the Department of Medicine, Boston University Medical Center, Mass.
Correspondence to P. Christian Schulze, MD, PhD, Department of Medicine, Boston University Medical Center, 80 E Concord St, Evans 124, Boston, MA 02115-2526. E-mail christian.schulze@bmc.org
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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Various treatment strategies have been developed to treat hypertension and affect its clinical outcome. These include early lifestyle modifications such as weight loss, nutritional changes, and exercise as well as pharmacological interventions that are based on diuresis, inhibition of the renin-angiotensin system, calcium channel blockade, central and peripheral sympatolysis, as well as
- and ß-receptor blockade.1 In individuals with prehypertension and patients with established hypertension, initial treatment, before the administration of pharmacological therapies, focuses on lifestyle changes targeting nutrition and exercise.1 In particular exercise is an intervention that is widely prescribed and recommended. Multiple clinical trials have shown effects of exercise on blood pressure with an average reduction of –10 mm Hg systolic and –8 mm Hg diastolic.2 Unfortunately, exercise is notoriously difficult to observe, evaluate, and dose in an outpatient population with hypertension.2,3
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Exercise as a Physiological Cardiovascular Intervention |
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Exercise is a physiological intervention with a broad variety of positive cardiovascular effects that include changes in lipid metabolism, insulin resistance, weight, arterial hypertension, inflammation, endogenous anabolism, and mood.2 It seems, in fact, reasonable to hypothesize that metabolic abnormalities associated with the primarily sedentary lifestyle in modern Western civilizations are not only counteracted but normalized by physical activity. Therefore, regular exercise would be a physiological correction rather than a medical treatment intervention.
Exercise programs distinguish between primarily aerobic dynamic (eg, running and cycling) and resistance (eg, strength training) exercises. Dynamic exercise with alternating muscle contraction and relaxation results in a steady rise of systolic blood pressure when intensity increases, whereas the diastolic pressure varies minimally. In
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Hypertension 2007 50: 410-416.
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  M. Miyachi, H. Yazawa, M. Furukawa, K. Tsuboi, M. Ohtake, T. Nishizawa, K. Hashimoto, T. Yokoi, T. Kojima, T. Murate, et al. Exercise Training Alters Left Ventricular Geometry and Attenuates Heart Failure in Dahl Salt-Sensitive Hypertensive Rats Hypertension, April 1, 2009; 53(4): 701 - 707. [Abstract] [Full Text] [PDF]
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