Slide 1Slide 2Slide 3Slide 4Slide 5Hagberg et al. (1989) Study DesignSlide 7Slide 8Hagberg et al. (1989) Study SummarySlide 10Slide 11Slide 12Slide 13Kokkinos et al. (1995) Study DesignKokkinos et al. (1995) Study ResultsKokkinos et al. (1995) Study ResultsSex differences in response to exercise trainingsDSlide 19Slide 20Summary: Blood Pressure & ExerciseTreating Hypertension with ExerciseExperimental StudiesLecture 2Variability in SBP Reductions with Exercise Training (24 weeks) in Patients with HypertensionVariability in DBP Reductions with Exercise Training (24 weeks) in Patients with HypertensionFactors Influencing BP Changes with Aerobic Exercise Training in Hypertensives•Training intensity•Training length•Age•Ethnicity•Gender•Genetics Training Intensity <70% VO2max 70% VO2maxSystolic blood pressureWeighted average reduction 11.1 mmHg 7.6 mmHgGroups with significant reductions (%) 79 75Total sample size 684 386Diastolic blood pressure Weighted average reduction 7.6 mmHg 6.7 mmHg Groups with significant reductions (%) 81 81 Total sample size 764 317 Effect of Exercise Training Intensity on SBP and DBP Changes in HypertensivesHagberg, Park, and Brown. Sports Med 30(3): 193-206, 2000.Hagberg et al. (1989) Study Design•60-69 yr old men and women with essential hypertension•Control group included•2 aerobic exercise training intensities–50% and 70% of VO2max•All groups restudied after 3 and 9 months3 mos. 9 mos. 3 mos. 9 mos.3 mos. 9 mos. 3 mos. 9 mos.Hagberg et al. (1989) Study Summary•Evidence that low- to moderate-intensity aerobic exercise training lowers blood pressure in hypertensives the same or more than higher intensity trainingEffect of exercise (three or seven sessions/week) on blood pressure in hypertensivesNelson et al. 1986cycling45’/day60-70% VO2max Training Program Length (weeks) 1-10 11-20 21+ Systolic blood pressureWeighted average reduction 9.8 mmHg 10.9 mmHg 11.1 mmHgGroups with significant reductions (%) 67 78 75 Total sample size 299 773 212 Diastolic blood pressure Weighted average reduction 8.4 mmHg 7.9 mmHg 9.1 mmHg Groups with significant reductions (%) 90 78 86 Total sample size 229 818 214 Effect of Exercise Training Length on SBP and DBP Changes in HypertensivesHagberg, Park, and Brown. Sports Med 30(3): 193-206, 2000. Average Age (years) 21-40 41-60 61+ Systolic blood pressureWeighted average reduction 8.7 mmHg 11.7 mmHg 7.6 mmHgGroups with significant reductions (%) 44 85 60 Total sample size 205 902 164 Diastolic blood pressure Weighted average reduction 10.4 mmHg 8.5 mmHg 8.8 mmHg Groups with significant reductions (%) 86 82 75 Total sample size 179 1014 55 Effect of Age on SBP and DBP Changes with Training in HypertensivesHagberg, Park, and Brown. Sports Med 30(3): 193-206, 2000. Ethnic Group Asians and Caucasians Pacific Islanders Systolic blood pressureWeighted average reduction 8.0 mmHg 11.7 mmHgGroups with significant reductions (%) 65 91 Total sample size 554 337 Diastolic blood pressure Weighted average reduction 6.8 mmHg 6.7 mmHg Groups with significant reductions (%) 75 85 Total sample size 515 310Effect of Ethnicity on SBP and DBP Changes with Training in HypertensivesHagberg, Park, and Brown. Sports Med 30(3): 193-206, 2000.Kokkinos et al. (1995) Study Design•African American men (35-76 years old) with severe hypertension (BP > 180/110 mmHg)•Medications taken to lower DBP to < 95 mmHg or 10 mmHg lower than initial value•Sedentary control group and aerobic exercise training group•Then 16 and 32 weeks of exercise training–cycle 3x/wk 60-80% max HRKokkinos et al. (1995) Study Results•Hypertensive medications were able to be reduced in 10 of the 14 exercisers for weeks 16 to 32 of the study CONTROL GROUPEXERCISE GROUPBASELINE BP 139/88 mmHg 138/88 mmHg16 WEEK BP 138/90 mmHg 131/83 mmHg*32 WEEK BP 138/90 mmHg 129/85 mmHg*Kokkinos et al. (1995) Study Results•Regular exercise + medications decreased BP more than medications alone in African American men with hypertension•Regular exercise reduced the need for BP medication in African American men with hypertensionSex differences in response to exercise training17 For endurance training, men had a greater improvement in blood pressure than women Effects were similar between sexes for dynamic resistance trainingCornelissen and Smart, JAHA. 2013sDDiaz & Shimbo 2013Overall Effect of Exercise Training on Systolic BP (SBP) in Hypertensives•76% of groups (56 of 74) decreased SBP significantly with exercise training•Reduction averaged 10.6 mmHg from an average initial value of 153 mmHg•Review of strength training studies show net changes in SBP of -3.2mmHgHagberg, Park, and Brown. Sports Med 30(3): 193-206, 2000.Cornelissen and Fagard, 2005Overall Effect of Exercise Training on Diastolic BP (DBP) in Hypertensives•81% of groups (59 of 73) decreased DBP significantly with exercise training•Reduction averaged 8.2 mmHg from an average