Exercise, arterial stiffness and myocardial oxygen demand in prehypertensive patients

This study examined the effect of resistance and endurance training on blood pressure, arterial stiffness and myocardial oxygen demand in prehypertensive patients.

To accommodate normal blood flow, arteries must be elastic and flexible. Throughout life, arteries become less elastic and stiffer. High blood pressure, high cholesterol levels and smoking contribute and accelerate this process. Stiff arteries require the heart to pump blood more forcefully, which elevates blood pressure. Since the heart is forced to work harder, arterial stiffness is also a major factor in the development of heart attacks (myocardial infarctions) and heart failure. Myocardial oxygen demand (the amount of oxygen the heart muscle requires) is an indicator of the amount of work that the heart must perform in order pump blood effectively.

Endurance and resistance training are both exercise programs which are known to be helpful in reducing blood pressure. This trial investigated whether arterial stiffness and myocardial oxygen demand may also be reduced from these training programs.

In this study, 43 prehypertensive patients (patients with an average blood pressure of 120-139 mmHg over 80-89 mmHg) were randomly assigned to three groups; Resistance Training (PHRT; including mainly strength exercises), Endurance Training (PHET; including mainly walking and running exercises), and a control group (PHTC; time control group with no exercise performed).  A second control group included 15 healthy patients without hypertension. Patients in the PHRT and PHET groups exercised for one hour per day, three days a week, for eight weeks. Blood pressure, myocardial oxygen demand, and pulse wave velocity (PWV; a measurement of arterial stiffness) were measured throughout the study.

PHRT and PHET reduced both SBP (systolic blood pressure; as measured when the heart muscle is contracted) and DBP (diastolic blood pressure; as measured when the heart muscle is relaxed) compared to the control groups. On average, PHRT reduced SBP by 9.6 mmHg and DBP by 8.0 mmHg, while PHET reduced SBP by 11.9 mmHg and DBP by 7.2 mmHg. Myocardial oxygen demand and PWV were also significantly reduced in both exercise groups, but not in any of the control groups. A slight advantage was shown towards PHET over PHRT, but this difference was not significant.

Endurance and resistance training can reduce arterial stiffness, myocardial oxygen demand and blood pressure in prehypertensive patients.

This trial included a very small number of participants in each group. In addition, all patients in this study were young (under the age of 35) and otherwise healthy.

Consult with your physician regarding the benefits of different exercise programs in treating hypertension and reducing the risk of serious complications.