Aerobic exercise training fails to reduce blood pressure in nondipper-typehypertension

To assess whether aerobic exercise training is an effective and an alternat ive method to control blood pressure (BP) in hypertension, 32 uncomplicated , never treated patients suffering from mild-to-moderate essential arterial hypertension (EAH) were included in an aerobic exercise training program u sing a regular standardized cycle ergometer exercise for 3 months. In all E AH patients, before and after the exercise training period, ambulatory BP m onitoring (ABPM) was performed and several metabolic variables were assesse d. Before exercise, in 20 EAH patients, a 48-h ABPM showed a normal day-nig ht rhythm, with nocturnal BP decrease, according to a dipper-type hypertens ion, whereas in 12 EAH patients 48-h ABPM profile indicated a nondipper-typ e hypertension. After exercise, EAH dippers presented a significant decreas e in the daytime systolic and diastolic BP, whereas EAH nondippers did not show any change in daytime and nighttime systolic and diastolic BP. Our stu dy confirms the controversy about the postulated BP lowering effect of dyna mic exercise in EAH patients, in the sense that only EAH dipper patients se em to obtain a beneficial diurnal lowering BP effect deriving from exercise , possibly through a reduction in sympathetic tone. On the contrary, physic al activity seems to fail in reducing diurnal and nocturnal BP values in EA H nondippers, suggesting that in nondipper-type hypertension, other "maskin g" endogenous or exogenous factors could interfere with and prevail over th e adrenergic-vagal balance that modulates the day-night BP synchronism. Am J Hypertens 2000; 13:593-600 (C) 2000 American Journal of Hypertension, Ltd .