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Exercise Training Combined With Antihypertensive Drug TherapyEffects on Lipids, Blood Pressure, and Left Ventricular Mass
Michael H. Kelemen, MD;
Mark B. Effron, MD;
Stephen A. Valenti, MD;
Kerry J. Stewart, EdD
JAMA. 1990;263(20):2766-2771.
Abstract
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We studied exercise training combined with the use of antihypertensive drugs and examined the following questions. (1) Are there additive antihypertensive benefits with exercise and drug therapy combined? (2) Does drug therapy limit exercise-induced lipid improvements? (3) Does exercise that includes weight training and walking/jogging affect the left ventricle? Fifty-two hypertensive men were randomly assigned, double-blind, to diltiazem hydrochloride, sustained release (360 mg daily), propranolol hydrochloride (240 mg daily), or placebo and exercised three times per week for 10 weeks. Baseline blood pressure (145/97 mm Hg) fell after training (131/84 mm Hg) in all groups. Exercise decreased total and low-density lipoprotein cholesterol levels in all groups. Increases in the levels of high-density lipoprotein cholesterol were similar in placebo and diltiazem groups, whereas the propranolol group changed in an opposite direction. In all groups, left ventricular mass increased with training, while diastolic function was unchanged. We conclude that (1) drug therapy provided no additive benefit to the antihypertensive effects of exercise, (2) propranolol limited improvements in high-density lipoprotein cholesterol, and (3) exercise did not adversely affect the left ventricle.
(JAMA. 1990;263:2766-2771)
Author Affiliations
From the Department of Medicine, The Columbia Medical Plan, Columbia, Md (Dr Kelemen); the Division of Cardiology, The Johns Hopkins School of Medicine, at The Francis Scott Key Medical Center, Baltimore, Md (Drs Effron and Stewart); and Howard County General Hospital, Columbia, Md (Dr Valenti). Dr Effron is now with Sinai Hospital of Baltimore, Md.
Footnotes
Reprint requests to Columbia Medical Plan, 2 Knoll North, Columbia, MD 21045 (Dr Kelemen).
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