title: Too old to benefit from sports? The cardiovascular effects of exercise training in elderly subjects treated for isolated systolic hypertension.
abstract: BACKGROUND
  Hypertension in the elderly is commonly characterized by an elevation of pulse pressure. With regard to advanced arteriosclerosis and limited physical fitness, doubt was casted whether elderly patients still achieve relevant cardiovascular benefits by physical exercise. The present work examines the impact of pulse pressure as a footprint of vascular ageing on cardiovascular benefits of endurance training in elderly hypertensives.
  
  
  METHODS
  54 patients > or =60 years with systolic 24-hour ambulatory blood pressure (ABP) >140 mm Hg and/or antihypertensive treatment and diastolic ABP < or =90 mm Hg were randomly assigned to sedentary activity or a 12-week treadmill exercise program (target lactate 2.5 +/- 0.5 mmol/l).
  
  
  RESULTS
  Exercise significantly decreased systolic and diastolic ABP by 8.5 +/- 8.2 and 5.1 +/- 3.7 mm Hg (p < 0.001 each) and increased physical performance. Arterial compliance remained unchanged, whereas endothelium-dependent vasodilation--measured by flow-mediated dilation--significantly increased from 5.6 +/- 1.7 to 7.9 +/- 3.0% (p < 0.007). After adjustment for initial systolic ABP, pulse pressure did not affect the change of BP.
  
  
  CONCLUSIONS
  The exercise-induced reduction of BP, which is mediated by improved endothelial function, is independent of pulse pressure. Thus, physical exercise is a helpful adjunct to control BP even in old hypertensives with markedly increased arterial stiffness.
authors.affiliation: Medizinische Klinik IV, Nephrology, Charité-Campus Benjamin Franklin (CBF), Berlin, Germany. westhoff@charite.de <westhoff@charite.de>
authors.forename: Timm H
authors.initials: TH
authors.lastname: Westhoff
authors.forename: Nadine
authors.initials: N
authors.lastname: Franke
authors.forename: Sven
authors.initials: S
authors.lastname: Schmidt
authors.forename: Katja
authors.initials: K
authors.lastname: Vallbracht-Israng
authors.forename: Romy
authors.initials: R
authors.lastname: Meissner
authors.forename: Havva
authors.initials: H
authors.lastname: Yildirim
authors.forename: Peter
authors.initials: P
authors.lastname: Schlattmann
authors.forename: Walter
authors.initials: W
authors.lastname: Zidek
authors.forename: Fernando
authors.initials: F
authors.lastname: Dimeo
authors.forename: Markus
authors.initials: M
authors.lastname: van der Giet
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013177:Sports / Q000502:physiology*; D013599:Systole / Q000502:physiology