Twenty-four hour ambulatory blood pressure monitoring to evaluate effects on blood pressure of physical activity in hypertensive patients

Objective: Elevated blood pressure is an important risk factor for cardiovascular disease and stroke. Several studies have demonstrated that physical exercise reduces blood pressure levels in hypertensive subjects and improves control of several well-known risk factors for atherosclerosis such as diabetes mellitus, blood lipid profile and obesity. Our group attempted to evaluate if an exercise program based on periodic controlled fast walking sessions would reduce blood pressure levels in hypertensive subjects. Design: We enrolled hypertensive subjects not suffering from obesity (Body Mass Index <30) already under pharmacological therapy; in these subjects we performed a six-week program of mobility exercise based on fast walking. Setting: Secondary care. Patients: We enrolled 189 subjects; 168 subjects completed the training period. Entry criteria were Stage I WHO hypertension in pharmacological treatment, BMI <30, and absence of any pathological condition resulting in reduced mobility. Interventions: A six-week mobility program centered on fast walking. Main Outcome Measurements: Systolic and diastolic blood pressure levels before and after the walking program. Results: Mean 24h systolic blood pressure changed from 143.1 to 135.5 mmHg. Mean 24h diastolic blood pressure changed from 91.1 to 84.8 mmHg. Conclusions: This reduction, evaluated with Ambulatory Blood Pressure Monitoring (ABPM), confirms that physical exercise should be a part of lifestyle changes for the management of hypertension both in untreated hypertensive patients or high-risk subjects for hypertension, and also for hypertensive patients in association with pharmacological therapy.