Exercise training is a well-established non-drug approach to blood pressure (BP) lowering, but limited evidence is available on its usefulness in individuals with resistant hypertension, a clinical population with low responsiveness to drug therapy. The Exercise Training in the Treatment of Resistant Hypertension (EnRicH) trial was a prospective, single-blinded randomized clinical trial aiming to close this knowledge gap. In August 2021, the trial’s results were published online in JAMA Cardiology.
A total of 60 patients with a diagnosis of resistant hypertension aged 40 to 75 years were prospectively enrolled in two centers in Portugal/ Patients were randomly assigned in a 1:1 ratio to a 12-week moderate-intensity aerobic exercise training program (exercise group) or a usual care control group. The exercise group performed three 40-minute supervised sessions per week in addition to usual care. The primary efficacy outcome was 24-hour ambulatory systolic BP change from baseline.
A total of 53 patients completed the study, including 26 in the exercise group and 27 in the control group. Of these, 45% were women, and the mean (SD) age was 60.1 (8.7) years. Compared with the control group, among those in the exercise group, 24-hour ambulatory systolic BP was reduced by 7.1 mm Hg (95% CI, −12.8 to −1.4; P = .02). Additionally, 24-hour ambulatory diastolic BP (−5.1 mm Hg; 95% CI, −7.9 to −2.3; P = .001), daytime systolic BP (−8.4 mm Hg; 95% CI, −14.3 to −2.5; P = .006), and daytime diastolic BP (−5.7 mm Hg; 95% CI, −9.0 to −2.4; P = .001) were reduced in the exercise group compared with the control group. The intervention group demonstrated significantly reduced office BP values as well as improved cardiorespiratory fitness.
These findings provide clinicians with evidence to embrace moderate-intensity aerobic exercise as a valuable coadjutant therapy targeting this patient population.
Reference: https://jamanetwork.com/journals/jamacardiology/article-abstract/2782554
