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Supervised versus recommended physical exercise in hypertensive women. Is its recommendation enough?
Bonet J, Coll R, Rocha E, Romero R
Blood Pressure 2003;12(3):139-134
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The aim of this study is to evaluate, in women with grade 1 essential hypertension, the response of cardio-respiratory and blood pressure (BP) after 6 weeks of supervised physical exercise (PE) versus only recommended exercise. METHODS: Eighteen consecutive hypertensive women whose BP control was stable were assigned randomly into two exercise groups. Group A including nine patients in an aerobic PE programme supervised by a physiotherapist, aged (mean +/- SD) 35.5 +/- 5.5 years old. Group B, nine patients aged 37.7 +/- 7.2 years old, received only oral and written instructions about the benefits of aerobic PE for controlling BP. We used a treadmill for walking to observe the cardio-respiratory and BP response at the beginning and at the end of the period of exercise training, and the response in all the patients, and to test whether there were any differences between the two groups. RESULTS: There were significant differences in cardio-respiratory parameters in group A, in basal VO2/kg post- versus pre-rehabilitation 27.6 +/- 5.1 versus 23.1 +/- 4.6, change 4.4 +/- 2; O2 pulse 10.9 +/- 0.9 versus 10.4 +/- 1.6, varied 0.5 +/- 0.1; furthermore we observed heart rate 73.3 +/- 12.37 versus 86.6 +/- 12.8, change -13.4 +/- 12.1 and metabolic equivalents of oxygen 9 +/- 1.2 versus 6.6 +/- 2.7, change 2.5 +/- 1.6, while in BP in group A, the differences were 153.1 +/- 7.1 versus 148.8 +/- 13.6, change -6.3 +/- 0.7 mm/g, p < 0.01 between pre- and post-rehabilitation. There were also significant differences between pre- and post-rehabilitation in group A in systolic BP 153 +/- 7.3 versus 135.1 +/- 16, change -18.1 +/- 4.1, p < 0.001 and diastolic BP 92.6 +/- 10.1 versus 83.5 +/- 9.1, change -9 +/- 4, p < 0.05; no change in group B. Finally, an improvement was observed in pulse pressure post-rehabilitation in group A 61.4 +/- 15.2 versus 51.6 +/- 11.4, change -9.8 +/- 3.9 versus group B 59.4 +/- 11.2 versus 59.3 +/- 10.6, only -0.1 +/- 0.8, p < 0.001. CONCLUSIONS: These results suggest that supervised PE in hypertensive women significantly improves cardio-respiratory and BP values, as well as vascular adaptability.

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