PRESCRIPTION AND RESULTS OF PHYSICAL-ACTIVITY

Epidemiologic studies suggest an inverse relationship between physical activity or fitness and blood pressure. In a meta-analysis of 36 controlled intervention studies, the weighted net blood pressure response to dynamic aerobic training averaged -5.3 mm Hg for systolic and -4.8 mm Hg for diastolic pressure. The variation of the change of blood pressure among studies was mainly dependent on the initial blood pressure level and the gain in exercise capacity. The weighted net change of blood pressure with endurance training averaged -3/-3 mm Hg in normotensive patients, -6/-7 mm Hg in borderline hypertensive patients, and -10/-8 mm Hg in hypertensive patients. Reductions of blood pressure have also been observed for measurements during exercise and during ambulatory monitoring. Exercise programs can contribute to the management of hypertension. Care is needed in the choice of antihypertensive drugs for the exercising patient because some drugs may impair exercise capacity.