Portugal: A 12-week aerobic exercise reduced office systolic BP and 24-hour and daytime ambulatory BP in patients with resistant hypertension, showed results from a recent study JAMA Cardiology. Therefore, moderate-intensity aerobic exercise can be incorporated into the standard of care of these patients with low responsiveness to drug treatment.
Resistant hypertension is a persistent clinical challenge that is a puzzling problem with no clear solution. The use of treatment options for lowering blood pressure (BP) such as antihypertensive medications and kidney denervation has limited success in such patients.
Although exercise is recommended as a first-line approach for hypertension treatment, there is a lack of specific recommendations for people with treatment-resistant hypertension.
Against the above background, Susana Lopes, School of Health Sciences, University of Aveiro, Aveiro, Portugal, and colleagues aimed to determine whether an aerobic exercise training intervention reduces ambulatory BP among patients with resistant hypertension in EnRicH trial.
The Exercise Training in the Treatment of Resistant Hypertension (EnRicH) trial is a prospective, 2-center, single-blinded randomized clinical trial performed at 2 hospital centers in Portugal from March 2017 to December 2019. The trial prospectively enrolled 60 patients with a diagnosis of resistant hypertension aged 40 to 75 years and observed at the hospitals' hypertension outpatient clinic.
53 patients were randomly assigned in the ratio of 1:1 to a 12-week moderate-intensity aerobic exercise training program (exercise group) or a usual care control group.
Patients were randomly assigned in a 1:1 ratio to a 12-week moderate-intensity aerobic exercise training program (exercise group; n=26) or a usual care control group (n=27). The exercise group performed three 40-minute supervised sessions per week in addition to usual care.
Key findings of the study include:
Compared with the control group, among those in the exercise group, 24-hour ambulatory systolic BP was reduced by 7.1 mm Hg.
Additionally, 24-hour ambulatory diastolic BP (−5.1 mm Hg), daytime systolic BP (−8.4 mm Hg), and daytime diastolic BP (−5.7 mm Hg) were reduced in the exercise group compared with the control group.
Office systolic BP (−10.0 mm Hg) and cardiorespiratory fitness (5.05 mL/kg per minute of oxygen consumption) also improved in the exercise group compared with the control group.
"A 12-week aerobic exercise program reduced 24-hour and daytime ambulatory BP as well as office systolic BP in patients with resistant hypertension," wrote the authors. "These findings provide clinicians with evidence to embrace moderate-intensity aerobic exercise as a standard coadjutant therapy targeting this patient population."
Reference:
The study titled, "Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial," is published in the journal JAMA Cardiology.
DOI: https://jamanetwork.com/journals/jamacardiology/fullarticle/2782554