Failure of Exercise to Reduce Blood Pressure in Patients With Mild Hypertension

Objective. —To assess the effects of physical exercise training on blood pressure in patients with mild hypertension.

Design. —Randomized controlled trial.

Setting. —Hospital-based cardiac rehabilitation program.

Patients. —Ninety-nine men and women with untreated mild hypertension (systolic blood pressure, 140 to 180 mm Hg; diastolic blood pressure, 90 to 105 mm Hg) were included in the volunteer sample.

Interventions. —Subjects were randomly assigned to a 4-month program of aerobic exercise training, strength and flexibility training, or to a waiting list control group.

Main Outcome Measures. —The main outcome measures were systolic and diastolic blood pressures measured four times with a random zero sphygmomanometer on 3 separate days in a clinic setting.

Results. —After 4 months of exercise training, subjects in the aerobic exercise group did not exhibit greater reductions in blood pressure than subjects in the control group. We expected a differential decline of 5 mm Hg between the aerobic exercise and waiting list control groups and found a difference of -1.0±16 mm Hg and -1.2±10 mm Hg at α=.05 for systolic and diastolic blood pressure, respectively.

Conclusions. —Moderate aerobic exercise alone should not be considered a replacement for pharmacologic therapy in nonobese patients with mild hypertension.

(JAMA. 1991;266:2098-2104)