Benefit of exercise in patients with hypertension insufficiently investigated

WASHINGTON - A new report has suggested that informative clinical studies are necessary to measure the implications of regular exercising on patients with increased blood pressure (hypertension).

People with increased blood pressure receive much well meant advice, for example, to adopt stress-management strategies, smoke less and drink less alcohol.

The researchers at German Institute for Quality and Efficiency and Health Care (IQWiG) were particularly interested firstly, to know whether people with hypertension, by exercising more, can actually reduce the risk of heart attacks or stroke, and secondly, to determine how more exercise affects their health-related quality of life.

Patients in the intervention group had been advised to exercise more over a longer period of time (e.g. cycling, running, hiking, swimming), while those in the control group had not been given this advice. In addition, only studies lasting 24 weeks or more were considered.

Overall, IQWiG and its external experts included 8 randomised controlled trials lasting 6 to 12 months in the assessment.

As the assessment showed, the studies considered in the report allow no conclusions on patient-relevant aspects of the benefit of increased physical activity in hypertension.

The studies did not provide sufficient results, neither on mortality, disease of the heart and circulatory system (cardiovascular morbidity), and kidney failure (end-stage renal disease), nor on health-related quality of life.

Sufficient data were also lacking on side effects (adverse events): as many elderly patients suffer from hypertension they could potentially have a higher risk of falling or injuring themselves.

In contrast, in all studies the effects of exercise on blood pressure were analysed. The data show that increased physical activity could lower the systolic (higher) value by 5 to 8 mmHg.

“To avoid misunderstandings: our conclusion is not that more exercise is useless or even harmful.

“However, it is a sobering fact that medications to lower blood pressure have been tested in dozens of large studies but we still know little about the advantages and disadvantages of physical activity, even though national and international professional associations have recommended this measure for a long time,” said Jurgen Windeler of IQWiG.

The German Institute for Quality and Efficiency and Health Care (IQWiG) published the results of a report. (ANI)