EFFECTS OF REGULAR EXERCISE ON BLOOD-PRESSURE AND LEFT-VENTRICULAR HYPERTROPHY IN AFRICAN-AMERICAN MEN WITH SEVERE HYPERTENSION

Background. The prevalence of hypertension and its cardiovascular comp lications is higher in African Americans than in whites. Interventions to control blood pressure in this population are particularly importa nt. Regular exercise lowers blood pressure in patients with mild-to-mo derate hypertension, but its effects in patients with severe hypertens ion have not been studied. We examined the effects of moderately inten se exercise on blood pressure and left ventricular hypertrophy in Afri can-American men with severe hypertension. Methods. We randomly assign ed 46 men 35 to 76 years of age to exercise plus antihypertensive medi cation (23 men) or antihypertensive medication alone (23 men). A total of 18 men in the exercise group completed 16 weeks of exercise, and 1 4 completed 32 weeks of exercise, which was performed three times per week at 60 to 80 percent of the maximal heart rate. Results. After 16 weeks, mean (+/-SD) diastolic blood pressure had decreased from 88+/-7 to 83i8 mm Hg in the patients who exercised, whereas it had increased slightly, from 88+/-6 to 90+/-7 mm Hg, in those who did not exercise (P=0.002). Diastolic blood pressure remained significantly lower after 32 weeks of exercise, even with Substantial reductions in the dose of antihypertensive medication. In addition, the thickness of the interv entricular septum (P=0.03), the left ventricular mass (P=0.02), and th e left-ventricular mass index (P=0.04) had decreased significantly aft er 16 weeks in the patients who exercised, whereas there was no signif icant change in the nonexercisers. Conclusions. Regular exercise reduc ed blood pressure and left ventricular hypertrophy in African-American men with severe hypertension.