By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.

Patients with severe hypertension are often afraid to exercise on the grounds that it may further raise the blood pressure, and most of the studies of the effects of exercise have been conducted in whites.

In this study 46 African-American men 35 to 76 years of age who had severe hypertension and enlarged hearts had their blood pressure treated with medications. Half of them were then assigned to a program of regular exercise, while the other half were on medication alone. The exercise program consisted of bicycling for 45 minutes at 75 per cent of maximal heart rate three times a week for 16 to 32 weeks.

After 16 weeks the blood pressure was 7 mm Hg lower in the group who exercised as compared to the sedentary group. The thickness of the heart muscle also decreased in the exercise group, but not in the others. The exercise program also reduced the number of blood pressure medications needed.

Doctor's comments

This is an important study and reaffirms the role that exercise can play in keeping down the blood pressure. Patients with enlarged hearts are at increased risk of having heart attacks, and it is thought that a reduction of the heart size is beneficial.

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