[Arterial hypertension and exercise]

Both dynamic and static exercise increase blood pressure in normotensive and hypertensive patients, but the change varies among these two main forms of exercise. The validity of the blood pressure response to acute exercise as a predictor for the future development of hypertension in normotensives, or of the degree of target organ damage in hypertensives is still not clear. This acute response could be an independent predictor of mortality or cardiovascular events in the normotensives. The postexercise hypotension could work as a beneficial mechanism to reduce the reduce the rise in pressure that occurs with time. While epidemiological studies suggest an inverse relationship between physical activity or fitness and blood pressure, longitudinal studies seem to confirm the hypotensive effect of dynamic aerobic training. Though possibly in a lesser degree, strength training has also been proved to be effective. Among the responsible mechanisms, a decrease in sympathetic nerve activity is most likely involved. Hypertension seems to be also associated with a lower maximal capacity, that could be even more adversely affected by the action of certain antihypertensive drugs such as diuretics or beta-blockers. All of these aspects have led to the acceptance of physical exercise among the non-pharmacological measures for the treatment of hypertension.