title: The impact of aerobic exercise on blood pressure variability.
abstract: There is increasing evidence that blood pressure variability (BPV, variation of blood pressure over time) constitutes a strong and independent marker of cardiovascular risk. The all-cause mortality is >50% greater in subjects with a standard deviation of inter-visit blood pressure >5 mm Hg. Regular aerobic exercise reduces blood pressure and is recommended by current hypertension guidelines as a basic lifestyle modification. It remains elusive, however, whether aerobic exercise is able to reduce BPV as well. In total, 72 hypertensive subjects were randomly assigned to an 8-12-week treadmill exercise program (target lactate 2.0±0.5 mmol l(-1)) or sedentary control. Blood pressure was measured by 24 h-ambulatory blood pressure monitoring (ABP). Two aspects of BPV were assessed: the variability of ABP and the variability of blood pressure on exertion. The coefficient of variation (CV) was used as a statistical measure of BPV. The CV of systolic daytime ABP was defined as primary outcome. The exercise program significantly decreased systolic and diastolic daytime ABP by 6.2±10.2 mm Hg (P<0.01) and 3.0±6.3 mm Hg (P=0.04), respectively. Moreover, it reduced blood pressure on exertion and increased physical performance (P<0.05 each). Exercise had no impact, however, on the CV of daytime (10.2±2.7 vs. 9.8±2.6%, P=0.30) and night-time systolic (8.9±3.2 vs. 10.5±4.1%, P=0.10) and diastolic ABP (daytime 11.5±3.3 vs. 11.5±3.1%, night-time 12.0±4.3 vs. 13.8±5.2%; P>0.05 each). Regular aerobic exercise is a helpful adjunct to control blood pressure in hypertension, but it has no effect on 24 h- BPV, an independent predictor of cardiovascular risk.
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Pagonas
authors.affiliation: Department of Sports Medicine, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Dimeo
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Bauer
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Seibert
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Kiziler
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Zidek
authors.affiliation: Department of Nephrology, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors.forename: T H
authors.initials: TH
authors.lastname: Westhoff
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D012016:Reference Values; D057185:Sedentary Behavior