[Physical activity, hypertension, and cardiac and circulatory system].
Because of its increasing incidence hypertension is--as one of the most important risk factor of diseases of the cardiac and circulatory system--a challenge for prevention and rehabilitation. Besides the established pharmacological therapy regular physical activity is one of the effective nonpharmacological therapies; particularly, there are also effects on other risk factors. Meta-analyses show a decreasing effect of physical activity both on the systolic and diastolic value. With a nonresponder rate of 25% the effects are similar to pharmacological therapy. Modulators can be found in the pathology of the disease itself, in the age, and in genetic polymorphisms. The mechanisms for blood pressure reduction might be the diuretic effect of physical activity, the reorganization of the vegetative reaction toward a sympathicolysis, the humeral modifications like changes in glucose metabolism and the improvement of endothelial function. Recommendations concerning the nature, the intensity and duration of physical activity refer more to consent statements than to evidence-based studies. Nevertheless, the following recommendations can be given. Endurance events with cyclic movements should be performed at a moderate intensity between 40% and 60% VO2(max). Though a duration of 60-90 min has the highest effect on blood pressure reduction, a duration of only 30 min per unit is favored to reach a higher compliance. No influence has yet been verified concerning the frequency of physical activity. Because of its effects on risk factors other than hypertension physical activity represents an all-embracing treatment concept. Therefore it is desirable to integrate physical activity in the treatment routine, especially in the therapy of patients with different risk factors.
Völker
Klaus
K
Institut für Sportmedizin, Universitätsklinikum Münster. klaus.voelker@uni-muenster.de
D001794:Blood Pressure / Q000502:physiology; D002319:Cardiovascular System / Q000503:physiopathology*; D003327:Coronary Disease / Q000503:physiopathology / Q000517:prevention & control; D015444:Exercise / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000534:rehabilitation; D012307:Risk Factors; D016896:Treatment Outcome