Physical Exercise in Hypertension, Randomised Clinical Trial

• Maximum oxygen uptake [ Time Frame: 1 year ] [ Designated as safety issue: No ]
• Endothelial function [ Time Frame: 1 year ] [ Designated as safety issue: No ]
• Echocardiographic left ventricular function [ Time Frame: 1 year ] [ Designated as safety issue: No ]
• Quality of life [ Time Frame: 1 year ] [ Designated as safety issue: No ]

• Maximum oxygen uptake
• Endothelial function
• Echocardiographich left vent4ricular function
• Quality of life

Endurance training has a documented effect on hypertension. However, only low to moderate training intensity has so far been studied. High aerobic intensity should, from physiological considerations, prove more effective in also reducing high blood pressure. The present study is a randomised comparison of high versus moderate intensity versus training in groups, and general advice on 24 hour blood pressure in hypertensives. The training period is 12 weeks, with follow-up after 1 year. Maximum oxygen uptake, quality of life, left ventricular function and blood vessel reactivity are also measured.

Endurance training has documented effect on blood pressure in hypertension. However, only low to moderate training intensity has so far been studied. Higher aerobic intensity based on individual measurements of maximum oxygen uptake is more efficient in increasing oxygen uptake, and might prove more effective in lowering blood pressure. Group training, on the other hand is not individualised, but less personnel required and may prove more cost effective. Endurance training is shown to improve both systolic and diastolic left ventricular function, as well as endothelial function. Both can be measured non-invasively by ultrasound.

The study is an open, randomised study with four arms, comparing:

• High aerobic intensity interval training
• Moderate aerobic intensity training
• Group training
• Controls receiving standard advice on lifestyle and training

Training effect is measured by Max. Oxygen uptake, blood pressure by continuous 24 hour ambulatory measurement, Left ventricular function by echo Doppler and endothelial function by flow mediated vasodilation by ultrasound.

The effect of exercise on blood pressure is dependent on continued training. All patients will be followed up after one year.

• Active Comparator: AIT: aerobic interval training
  High intensity interval training on treadmill at > 90% of maximal HR for four bouts of four minutes with warm up, active pauses and cool down, three times per week for 12 weeks.
  Intervention: Behavioral: Endurance exercise
• Active Comparator: MIT, moderate intenisity training
  Moderate intensity treadmill continuous exercise at 70% of maximum heart rate for 47 minutes (in order to ensure isocaloric training amount), three times per week for 12 weeks.
  Intervention: Behavioral: Endurance exercise
• No Intervention: Recommendation of regular exercise
  No training intervention, general advice as prescribed in guidelines.
  Intervention: Behavioral: Endurance exercise

Inclusion Criteria:

• Essential hypertension grade 1 - 2 without medical treatment

Exclusion Criteria:

• End organ damage
• Two or more cardiovascular risk factors
• Diabetes