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Exercise may be best medicine for hypertension

Wednesday December 19th, 2018

Exercise interventions may be as effective as most medication for hypertension, researchers say today.

Because hypertension is linked to cardiovascular disease, several types of drug have been used to lower blood pressure. As the rate of cardiovascular disease continues to rise, alternative options are being increasingly explored.

Dr Huseyin Naci at the London School of Economics, UK, and colleagues looked at nearly 400 published studies to compare the effect of exercise and medications on systolic blood pressure.

About half the trials were studies of antihypertensive drugs while the other half studied structured exercise.

The randomised controlled trials involved angiotensin-converting enzyme inhibitors, angiotensin-2 receptor blockers, beta-blockers, calcium channel blockers and diuretics as well as an updated meta-analysis of exercise interventions including endurance, dynamic resistance, isometric resistance, and combined endurance and resistance exercise.

For individuals with normal blood pressure at the start, antihypertensive drugs led to greater reductions in blood pressure than exercise, the researchers say.

But for individuals with high blood pressure, there were no significant differences in the effects of medications compared with endurance or dynamic resistance exercise.

Details are published in The British Journal of Sports Medicine today (19 December). The authors point out that one of the trials directly compared exercise against medications.

They conclude: "The effect of exercise interventions on systolic blood pressure remains under-studied, especially among hypertensive populations. Assuming equally reliable estimates, the systolic blood pressure-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications."

The researchers call for further studies to investigate the generalisability of these findings to real-world clinical settings.

Naci, H. et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. British Journal of Sports Medicine 19 December 2018 doi: 10.1136/bjsports-2018-099921

Tags: Fitness | Heart Health | Pharmaceuticals | UK News

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