Failure of exercise to reduce blood pressure in patients with mild hypertension. Results of a randomized controlled trial

OBJECTIVE.--To assess the effects of physical exercise training on blood pressure in patients with mild hypertension. DESIGN.--Randomized controlled trial. SETTING.--Hospital-based cardiac rehabilitation program. PATIENTS.--Ninety-nine men and women with untreated mild hypertension (systolic blood pressure, 140 to 180 mm Hg; diastolic blood pressure, 90 to 105 mm Hg) were included in the volunteer sample. INTERVENTIONS.--Subjects were randomly assigned to a 4-month program of aerobic exercise training, strength and flexibility training, or to a waiting list control group. MAIN OUTCOME MEASURES.--The main outcome measures were systolic and diastolic blood pressures measured four times with a random zero sphygmomanometer on 3 separate days in a clinic setting. RESULTS.--After 4 months of exercise training, subjects in the aerobic exercise group did not exhibit greater reductions in blood pressure than subjects in the control group. We expected a differential decline of 5 mm Hg between the aerobic exercise and waiting list control groups and found a difference of -1.0 +/- 16 mm Hg and -1.2 +/- 10 mm Hg at alpha = .05 for systolic and diastolic blood pressure, respectively. CONCLUSIONS.--Moderate aerobic exercise alone should not be considered a replacement for pharmacologic therapy in nonobese patients with mild hypertension.