Exercise in treating hypertension: tailoring therapies for active patients

Even mild-to-moderate elevations in blood pressure dramatically increase the risk of left ventricular hypertrophy, stroke, and renal disease. Although antihypertensive drugs can reduce blood pressure, their side effects and cost have stimulated a search for alternatives. Nonpharmacologic interventions can serve as definitive therapy for selected patients and as adjunctive therapy for many hypertensive patients. Patients with secondary hypertension should be treated directly and may not derive as much benefit from exercise. Low-to-moderate intensity aerobic exercise can help mildly hypertensive patients and reduce the drug dosage of those more severely affected. For active patients who require medication, regimens can be tailored to minimize adverse drug effects.