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Suggestions for Blood Pressure
Excerpt By Ira Dreyfuss, Associated Press

Life's frustrations can raise a person's blood pressure, but exercise and weight control can rein in the health risks, a study finds.

The boss can be just as demanding, and the kids just as ornery. However, a healthier lifestyle can reduce the chance that stress-related high blood pressure, over time, will lead to a heart attack or stroke, researchers said.

``The potential for decreased risk is that you are having less response to activities of daily living,'' said Patrick R. Steffen of Brigham Young University.

The six-month study, done while Steffen was at Duke University, looked at 112 overweight or obese men and women with an average age of 48. Their blood pressure at the start of the study was either high or just below the threshold for high, a condition called high-normal. Average systolic reading for the group, the high number of the two that comprise blood pressure, was about 142; the minimum for hypertension is 140.

Patients were divided into three groups. An aerobic exercise-only group worked out three or four times a week on stationary bikes or in a program that started with walking and worked up to jogging. An exercise-and-diet group did the same exercises and took part in a weight management program to shed one or two pounds a week. The third group maintained pre-study lifestyles, and served as a control.

The crucial part of the experiment happened while the participants were on their own. All wore ambulatory blood pressure cuffs that recorded readings automatically about four times an hour until bedtime. The inflation of the cuff was the participants' cue to make diary entries about their mood at the time, and what they were doing physically, such as watching TV, driving or walking.

The exercise-and-diet group had lower blood pressure readings during high emotional stress than did the exercise-only or the control group, the study found. Exercisers had some similar improvements but not nearly as pronounced.

Diet and exercise are common prescriptions for treatment of hypertension. But the study showed weight loss had a greater effect than exercise did, said the study's senior author, James A. Blumenthal of Duke.

``If you think you are lowering your blood pressure by exercise, it's not going to be all that much,'' Blumenthal said. ``Combining exercise with dietary changes is where you are going to see the change in daily life and under stress.''

Twenty-two of 33 participants in the diet-and-exercise group who had hypertension at the start of the program no longer were hypertensive at the end, Blumenthal said. The same could be said for 13 of 30 people who did only exercise, and 2 of 17 controls.

``To me, the results are pretty profound,'' said a separate researcher, Dr. Barry A. Franklin, director of cardiac rehabilitation at William Beaumont Hospital, Royal Oak, Mich. The findings show that exercise and diet don't just reduce stress reactions in the lab, they work in a patient's life, he said.

``In the long term, if this reduces reactivity to stress, there is good evidence it will reduce your likelihood of heart attack and stroke,'' said researcher Christopher R. France of Ohio University.

The findings, published in the October issue of the American College of Sports Medicine journal, Medicine and Science in Sports and Exercise, assume heightened importance because of a separate study published in the Nov. 1 issue of the New England Journal of Medicine.

The New England Journal article compared people with high-normal blood pressure to those with optimal pressure. The report said that over 10 years, those with high-normal blood pressure had a 150 percent to 250 percent greater risk of heart disease or stroke. Dr. Ramachandran Vasan of Boston University School of Medicine said his findings point out the need for lifestyle changes to reduce blood pressure.

On the Net:

Abstract of MedSci article: http://www.ncbi.nlm.nih.gov/PubMed; use Steffen and Blumenthal as search terms.

New England Journal article: http://content.nejm.org/cgi/content/short/345/18/1291

American Heart Association (news - web sites): http://www.americanheart.org


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