[The beneficial effect of physical training in hypertension]

Hypertension is present in epidemic proportion and is associated with a markedly increased risk of developing numerous cardiovascular disorders. All current treatment guidelines emphasise the role of nonpharmacological interventions, physical activity included, in the treatment of mild to moderate hypertension. A large number of studies have demonstrated that regular exercise reduces the incidence of hypertension. In addition to preventing hypertension, regular exercise has been found to lower blood pressure (10 mmHg average reduction in both systolic and diastolic pressure), improve lipoprotein-lipid profiles and insulin sensitivity. As part of the initial treatment, exercise is recommended for 12 months in patients with stage 1 hypertension, with no other coronary risk factors and no evidence of cardiovascular disease, and for as long as 6 months in those with other risk factor, but not diabetes. In patients with diabetes, cardiovascular disease or with stage 2 or 3 hypertension, drug therapy should be initiated first. Dynamic exercise of moderate intensity, 50-75% VO2max, (e.g. brisk walking, cycling) for 50-60 minutes, 3-5 times per week, is preferable to vigorous exercise because it appears to be more effective in lowering blood pressure. In addition to reducing hypertension, physical activity improves other cardiovascular risk factors.