(June 28, 2004) - Bethesda, MD Only recently was a type of diuretic known as thiazides been found to be superior to angiotensin-converting enzyme (ACE) inhibitors and calcium antagonists (calcium channel blockers) in preventing one or more major types of cardiovascular disease. The diuretics also tend to have fewer and less severe side effects, making it easier to stay on medication. In addition, the diuretics are relatively inexpensive. Exercise has always been recommended for good cardiac health.

So what should the at-risk, older American do to sustain good cardiac health?

Background

Hypertension or high blood pressure during the contraction of the heart is epidemic among older men and women. It is a major but modifiable risk factor for cardiovascular morbidity and mortality in old age. Left ventricular hypertrophy (LVH), or an enlarged heart, is commonly observed in a patient with hypertension and can be a powerful predictor of heart failure independent of level of blood pressure (BP) in hypertensive adults. Reduction of blood pressure during contraction can reduce the risk of stroke and heart failure in hypertensive older individuals. Furthermore, regression of LVH is likely to reduce cardiovascular risks in hypertension.

Endurance exercise training, which can include sustained walking, jogging or cycling, has been recommended for management of hypertension because it is effective in reducing blood pressure. Recent studies have shown that exercise training may also reduce left ventricular (LV) concentric remodeling and LVH. Since endurance exercise training improves increased levels of insulin in the plasma and insulin resistance it is possible that the benefits leading to increase in cardiac health may occur because insulin is a stimulus for the development of an enlarged heart. What is not clear is whether exercise can induce regression of LV remodeling in older adults or whether it is as effective as antihypertensiv
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29-Jun-2004

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