title: Effect of exercise on blood pressure in older persons: a randomized controlled trial.
abstract: BACKGROUND
  Because of age-related differences in the cause of hypertension, it is uncertain whether current exercise guidelines for reducing blood pressure (BP) are applicable to older persons. Few exercise studies in older persons have evaluated BP changes in relation to changes in body composition or fitness.
  
  
  METHODS
  This was a 6-month randomized controlled trial of combined aerobic and resistance training; controls followed usual care physical activity and diet advice. Participants (aged 55-75 years) had untreated systolic BP (SBP) of 130 to 159 mm Hg or diastolic BP (DBP) of 85 to 99 mm Hg.
  
  
  RESULTS
  Fifty-one exercisers and 53 controls completed the trial. Exercisers significantly improved aerobic and strength fitness, increased lean mass, and reduced general and abdominal obesity. Mean decreases in SBP and DBP, respectively, were 5.3 and 3.7 mm Hg among exercisers and 4.5 and 1.5 mm Hg among controls (P < .001 for all). There were no significant group differences in mean SBP change from baseline (-0.8 mm Hg; P=.67). The mean DBP reduction was greater among exercisers (-2.2 mm Hg; P=.02). Aortic stiffness, indexed by aortofemoral pulse-wave velocity, was unchanged in both groups. Body composition improvements explained 8% of the SBP reduction (P = .006) and 17% of the DBP reduction (P<.001).
  
  
  CONCLUSIONS
  A 6-month program of aerobic and resistance training lowered DBP but not SBP in older adults with mild hypertension more than in controls. The concomitant lack of improvement in aortic stiffness in exercisers suggests that older persons may be resistant to exercise-induced reductions in SBP. Body composition improvements were associated with BP reductions and may be a pathway by which exercise training improves cardiovascular health in older men and women.
authors.affiliation: Divisions of Cardiology, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD 21224, USA. kstewart@jhmi.edu
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Stewart
authors.forename: Anita C
authors.initials: AC
authors.lastname: Bacher
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Turner
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Fleg
authors.forename: Paul S
authors.initials: PS
authors.lastname: Hees
authors.forename: Edward P
authors.initials: EP
authors.lastname: Shapiro
authors.forename: Matthew
authors.initials: M
authors.lastname: Tayback
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
mesh_terms: D000368:Aged; D001011:Aorta / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D013997:Time Factors; D014891:Weight Lifting