DISCUSSION
Reduction in Blood Pressure with Exercise
We observed a significant reduction in diastolic blood
pressure and regression of left ventricular hypertrophy
in African-American men with severe hypertension after
16 weeks of moderately intense aerobic exercise. In
addition, exercising for more than 16 weeks resulted in
a further fall in blood pressure, permitting a substantial
reduction in antihypertensive medication.
Systolic blood pressure also decreased, by 7 mm Hg
and 6 mm Hg after 16 and 32 weeks of exercise, respectively.
Although these changes are clinically important,2
neither reached statistical significance.
Severe hypertension is difficult to manage and often
requires multiple antihypertensive medications for effective
control. Such complex treatments burden patients
financially and increase the possibility of adverse
effects and poor compliance. Our results show that
severe hypertension can be managed more effectively
with a combination of drug therapy and regular, moderately
intense exercise. Most important, medications
necessary to control blood pressure
without exercise can be curtailed
substantially as patients continue
exercising.