Work off high blood pressure with exercise, not drugs

August 16, 2000

DALLAS, Aug. 18 -- A program of regular exercise and weight loss can be a first option for treating overweight individuals with moderately high blood pressure -- and may keep them from having to take anti-hypertensive drugs, according to a study in this month's Hypertension: Journal of the American Heart Association.

Reducing blood pressure through exercise and weight loss could move many people from Stage 1 hypertension into the "high normal" category and many others from "high normal" to "normal," says study author Anastasia Georgiades, Ph.D., of the department of psychiatry and behavioral science at Duke University Medical Center.

Normal blood pressure is a systolic pressure (top number) less than or up to 130 millimeters of mercury (mmHg) and a diastolic pressure (bottom number) up to 85 mmHg. A blood pressure reading of 130-139 systolic over 85-89 diastolic is in the "high normal" range. A person with systolic pressure between 140-159, and diastolic pressure from 90-99mmHg, is said to have Stage 1 hypertension.

The research, carried out at Duke University Medical Center, Durham, North Carolina, placed particular emphasis on the importance of reducing blood pressure at times of increased mental stress.

"Our results show that exercise and weight loss helped to keep blood pressure lower even when individuals were under mental stress," says Georgiades. "Like high blood pressure itself, an exaggerated cardiovascular response to mental stress is an additional risk factor for heart disease. By lowering stress-induced blood pressure levels and altering other physiological responses to stress, exercise and weight loss may prevent future damage to blood vessels and the heart."

Exercise and weight management programs also resulted in health benefits such as a lower heart rate, more efficient pumping of the heart, greater dilation of blood vessels and a higher overall level of fitness, according to the study.

The 99 individuals who completed the six-month study were divided into three groups: (1) those who combined exercise with a calorie- and fat-restricted weight-loss diet, (2) those who exercised but didn't follow the weight-loss program, and (3) a control group that did neither.

All participants were moderately overweight men and women aged 29 or older with sedentary lifestyles and blood pressures ranging from 130 to 180 systolic (the upper figure in blood pressure readings) and 85 to 105 diastolic (the lower figure).

For individuals in the exercise/weight loss group, their systolic pressure dropped an average of eight points, and diastolic pressure declined by an average of six points. In the exercise-only group, the average systolic reading dropped by 3.5 points and the average diastolic reading by five points.

Meanwhile, the control group showed a decrease of two points in the average systolic reading, while the diastolic pressure remained unchanged, Georgiades says.

Study participants had their blood pressure and heart rates checked during such stressful situations as simulated public speaking and anger recall. Those who followed the weight-loss diet (1,200 calories daily for women and 1,500 for men) and exercise program (45 minutes of fast walking three or four times per week), as well as those in the exercise-only group, showed a reduced overall cardiovascular reaction to stress.

Patients in the exercise/weight loss group lost an average of about 15 pounds during the six months, Georgiades notes. Those in the exercise-only group lost an average of 3.5 pounds. "Our goal was for the exercise/weight loss group to lose only a pound or so per week, and the results were remarkably consistent," she says.

"This study shows that exercise in combination with weight loss is an effective drug-free treatment for elevated blood pressure in mild to moderately obese individuals," Georgiades concludes.
Co-authors include Andrew Sherwood, Ph.D.; Elizabeth C. D. Gullette, Ph.D.; Michael A. Babyak, Ph.D.; Andrew Hinderliter, M.D.; Damon Tweedy, M.D.; Linda Craighead, Ph.D.; Richard Bloomer, M.S.; and James A. Blumenthal, Ph.D.

NR00-1163 (Hyper/Georgiades)

For journal copies only, please call: 214-706-1173

American Heart Association

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