The cardiovascular effects of upper-limb aerobic exercise in hypertensive patients.
BACKGROUND
Aerobic exercise is broadly recommended as a helpful adjunct to obtain blood pressure control in hypertension. Several hypertensive patients, however, are limited by musculoskeletal complaints or vascular occlusive disease from lower-limb exercise such as jogging or cycling. In the present randomized-controlled study, we evaluate whether an aerobic arm-cycling program provides a measurable cardiovascular benefit.


METHODS
Twenty-four probands were randomly assigned to sedentary activity or a heart rate controlled 12 week exercise program, consisting of arm-cycling at target lactate concentrations of 2.0 +/- 0.5 mmol/l. Endothelial function was assessed by flow-mediated dilation of the brachial artery. Augmentation index and large/small artery compliance (C(1) and C(2)) were measured by computerized pulse-wave analysis of the radial artery.


RESULTS
The exercise program led to a significant reduction in systolic (134.0 +/- 20.0 to 127.0 +/- 16.4 mmHg; P = 0.03) and diastolic blood pressure (73.0 +/- 21.6 to 67.1 +/- 8.2 mmHg; P = 0.02) accompanied by a significant improvement in C(2) (3.5 +/- 1.6 to 4.8 +/- 2.0 ml/mmHg x 100; P = 0.004). Flow-mediated dilation, augmentation index, and C(2) were not significantly affected (P > 0.05). Physical performance as derived from lactate and heart rate curves of lower-limb stress tests was unchanged, whereas maximal workload in an upper-limb ergometry significantly increased (P = 0.005). Blood pressure and vascular parameters remained unchanged in the control group.


CONCLUSIONS
Regular arm aerobic exercise leads to a marked reduction in systolic and diastolic blood pressures and an improvement in small artery compliance. Arm-cycling is a reasonable option for hypertensive patients who want to support blood pressure control by sports despite having coxarthrosis, gonarthrosis, or intermittent claudication.
Department of Nephrology, Charité Campus Benjamin Franklin, Hindenburgdamm, Berlin, Germany. timm.westhoff@charite.de
Timm H
TH
Westhoff
Sven
S
Schmidt
Viola
V
Gross
Marian
M
Joppke
Walter
W
Zidek
Markus
M
van der Giet
Fernando
F
Dimeo
D000368:Aged; D001916:Brachial Artery / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D034941:Upper Extremity / Q000503:physiopathology*