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Endurance exercise found to be equally effective as diuretics in improving cardiac health

ndex and relative wall thickness in older adults with mild hypertension. The data also suggests that the extent of this reversal is likely to be similar to that induced by thiazide diuretic.

Additionally, the researchers found that the reduction in systolic blood pressure with thiazide was greater than with exercise training.

The regression of LVH in the volunteers is evidenced by reductions in the LV wall thickness-to-radius ratio, LV posterior and septal wall thicknesses without an increase in LV end-diastolic diameter or volume, and LV mass normalized for body surface area or fat-free mass. The absence of a significant change in LV end-diastolic diameter or volume suggests that the training stimulus was not sufficiently vigorous to induce superimposed volume-overload hypertrophy.

Conclusions

The findings of this study suggest that a program of mild-to-moderate intensity exercise training can result in partial regression of increased LV relative wall thickness and LVH that is similar to the effect induced by a thiazide diuretic.

Although hydrochlorothiazide is considerably more effective in reducing systolic blood pressure than exercise, metabolic adaptations that occur only with exercise training can provide significant additional clinical benefits that are not attainable with a thiazide diuretic.

Therefore, endurance exercise training appears to be a suitable treatment strategy in some older adults with mild hypertension because despite a smaller decrease in blood pressure, it can induce a comparable regression of cardiac mass with improvements in insulin resistance and aerobic capacity and because aggressive reduction of blood pressure by antihypertensive medications may not necessarily confer a greater protection against the risk of death in hypertensive elderly patients.


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29-Jun-2004


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