The long-term effect of exercise on blood-pressure (BP) was assessed in 13 untreated patients with essential hypertension. After a 6-week run-in period the levels of activity studied were (i) sedentary, (ii) 45 min bicycling at 60 to 70% of maximum work capacity (Wmax) three times per week (3/week), and (iii) 45 min bicycling seven times per week (7/week), each for 4 weeks. The order differed between subjects in accordance with a Latin square. Supine BP, 48 h after each phase, averaged 148/99 mmHg in the run-in and 143/96 mmHg in the sedentary phase; it fell below values in the sedentary phase by 11/9 mmHg with 3/week exercise, and by 16/11 mmHg with 7/week exercise (both p < 0.01). With increasing activity total peripheral resistance fell and the cardiac index rose. Plasma noradrenaline concentration fell below values in the sedentary phase by 21% and 33% after 3/week and 7/week exercise. Bodyweight and 24 h sodium excretion remained constant. Moderate regular exercise lowers BP and seems to be an important non-pharmacological method of treating hypertension.

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