COMPARISON OF SINGLE VERSUS MULTIPLE LIFE-STYLE INTERVENTIONS - ARE THE ANTIHYPERTENSIVE EFFECTS OF EXERCISE TRAINING AND DIET-INDUCED WEIGHT-LOSS ADDITIVE

Although aerobic exercise training and diet-induced weight loss each h ave been shown to individually lower elevated blood pressure (BP), it is currently not known whether their combined use produces an additive antihypertensive effect. In this randomized clinical trial we therefo re compared the effect on resting BP of exercise training only and die tary modification only with that of exercise training plus dietary mod ification in 55 sedentary, overweight patients with high normal BP or stage 1 or 2 hypertension. After baseline testing, patients were rando mized to 1 of the following 3 interventions for 12 weeks: exercise tra ining only (aerobic exercise; 30 to 45 minutes; 3 to 5 days/week; 60% to 85% of maximal heart rate), dietary modification only (aimed primar ily at weight loss via restriction of energy intake and dietary fat), or exercise training plus dietary modification. Forty-eight patients c ompleted the study. In these patients, exercise training plus dietary modification elicited a greater reduction (p less than or equal to 0.0 01) in body weight (-7.1 +/- 2.9 vs -1.0 +/- 1.8 kg) than exercise tra ining only, and a greater increase (p less than or equal to 0.05) in m aximal oxygen uptake (4.3 +/- 2.6 vs 1.9 +/- 2.0 ml/kg/min) verses die tary modification only. However, the reduction in BP with exercise tra ining plus dietary modification (-12.5 +/- 6.3/7.9 +/- 4.3 mm Hg) did not differ significantly from that with exercise training only (-9.9 /- 6.4/5.9 +/- 4.6 mm Hg) or dietary modification only (-11.3 +/- 12.1 /7.5 +/- 4.3 mm Hg). These data indicate that the antihypertensive eff ects of exercise training and diet-induced weight loss are not additiv e. This finding has important public health and clinical implications for the millions of overweight persons with high normal BP or stage 1 or 2 hypertension. (C) 1997 by Excerpta Medica, Inc.