title: Effects of exercise and weight loss on blood pressure during daily life.
abstract: OBJECTIVE
  The objective of this study was to investigate the effects of exercise training and weight loss on blood pressure (BP) associated with physical activity and emotional stress during daily life.
  
  
  METHODS
  One hundred twelve participants with unmedicated high normal or stage 1 to stage 2 hypertension were randomized to one of three conditions: a combined exercise and behavioral weight management group (WM), an exercise-only group (EX), or a wait list control group (CON). BP was assessed in the clinic and during 15 h of daytime ambulatory BP monitoring at baseline and after 6 months of treatment.
  
  
  RESULTS
  Increased levels of physical activity and emotional distress measured during daily life were associated with increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and rate pressure product (RPP). After treatment, the WM group had significantly lower DBP, HR, and RPP responses during both high and low levels of physical activity and emotional distress compared with the CON group. The EX group had similar BP levels as the WM group, although the EX group had significantly lower BP than the CON group during low but not high levels of physical activity and emotional distress.
  
  
  CONCLUSIONS
  These findings indicate that exercise, especially when combined with weight loss, reduces BP levels at rest and in situations that typically elevate BP such as intense physical activity and emotional distress.
authors.affiliation: Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Steffen
authors.forename: A
authors.initials: A
authors.lastname: Sherwood
authors.forename: E C
authors.initials: EC
authors.lastname: Gullette
authors.forename: A
authors.initials: A
authors.lastname: Georgiades
authors.forename: A
authors.initials: A
authors.lastname: Hinderliter
authors.forename: J A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D000203:Activities of Daily Living; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D017063:Outcome Assessment, Health Care; D013315:Stress, Psychological; D015431:Weight Loss / Q000502:physiology*