Postgraduate Medicine

ISSN: 0032-5481 (Print) 1941-9260 (Online) Journal homepage: http://www.tandfonline.com/loi/ipgm20

Hypertension and exercise Rachel A. Yeater PhD & Irma H. Ullrich MD To cite this article: Rachel A. Yeater PhD & Irma H. Ullrich MD (1992) Hypertension and exercise, Postgraduate Medicine, 91:5, 429-436, DOI: 10.1080/00325481.1992.11701304 To link to this article: http://dx.doi.org/10.1080/00325481.1992.11701304

Published online: 17 May 2016.

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Date: 19 June 2016, At: 03:42

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Hypertension and exercise Where do we stand?

Rachel A. Yeater, PhD

lnna H. Ullrich, MD

Downloaded by [University of Toronto Libraries] at 03:42 19 June 2016

Preview Studies through the years have suggested that regular aerobic exercise may benefit patients with hypertension. However, because methods in these studies were not standardized, the authors undertook their own research to shed light on unanswered questions in the literature. Their results and recommendations are reported here.

According to epidemiologic data, premature cardiovascular morbidity and mortality are directly related to elevated systolic and diastolic blood pressure. The higher the pressure, the greater the risk of disease. However, because so many people have mild hypertension (diastolic pressure, 90 to 104 mm Hg), most cases of cardiovascular morbidity and mortality come from this group. 1

health problem for US blacks. 1 The etiology of primary, oressential, hypertension is still unknown, but several risk factors have been identified. These include weight gain as fat (especially if centrally located), family history, high-normal blood pressure at an early age, sedentary life-style, increasing age, and excessive alcohol ingestion. 1

Prevalence and risk factors It is estimated that 58 million

The goal of hypertension therapy is to achieve and maintain pressure below 140/90 mm Hg. Many clinical trials have shown that pharmacologic therapy is beneficial, but the decision to start medication depends on the severity of the hypertension and the presence of other complications. Because drug therapy may produce adverse side effects, nonpharmacologic approaches may be preferred for patients with mild hypertension and should also be used as adjuncts when pharmacologic therapy is considered necessary. 2

Nonphannacologic therapy people in the United States have hypertension, which is defined as systolic pressure higher than 140 mm Hg and/or diastolic pressure of90 mm Hg in a person not taking medication. Table 1 shows the classification of blood pressure in persons aged 18 years or older. 2 Prevalence of hypertension is greater in blacks (38%) than in whites (29%). 1 The condition also develops at an earlier age in blacks and is more severe. In fact, hypertension is the most serious

Nonpharmacologic treatment programs include the following: • Weight reduction. Even minimal weight loss can result in significant decreases in both systolic and diastolic blood pressure. In the United States, 53% of obese persons are hypertensive, compared with only 22% of nonobese persons. 1 However, weight loss is difficult to achieve, and in most cases the weight is regained. • Alcohol restriction. To help control hypertension, alcohol should be limited to 1 oz of ethanol daily. This is the equivalent of 2 oz of 100-proof whiskey, 8 oz of wine, or 24 oz of beer. 2 • Sodium restriction. Moderate sodium restriction (daily intake of 1.5 to 2.5 g) controls mild hypertension in some salt-sensitive patients. 2 Sodium restriction is also effective as an adjunct to pharmacologic therapy. It is not possible, however, to predict which patients will respond to sodium restriction. Therefore, many physicians recommend it for all hypertensive patients. • Exercise. Aerobic activity that uses large muscle groups is advised for hypertension controU It should be done for 20 to 60 minutes a day for a minimum of 3 days a week (see box on page 431). Although the physiologic mechanisms responsible for lowering of blood pressure as a result

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VOL 91/NO 5/APRIL 1992/POSTGRADUATE MEDICINE • HYPERTENIIION

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Strong epidemiologic and experimental evidence supports a link between exercise and lowering of blood pressure.

Table 1. Classification of blood pressure in patients 18 years of age or older

Classification

Systolic BP (mm Hg) when diastolic BP is

Hypertension and exercise. Where do we stand?

Several risk factors have been identified in patients with essential hypertension. The question is whether regular exercise programs can either preven...
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