TREATMENT OF HYPERTENSION WITH TWO EXERCISE INTENSITIES
Project Number7R01HL056907-03
Contact PI/Project LeaderPOSNER, JOEL D
Awardee OrganizationMCP HAHNEMANN UNIVERSITY
Description
Abstract Text
DESCRIPTION: (Adapted from Investigator's Abstract) Arterial hypertension
affects over 50 million Americans. While drug treatment is effective,
exercise would be safer, might be cheaper, and would bring added health
benefits if it could replace drugs in controlling hypertension. The aims of
this study are to: 1) determine if two 18 month long endurance training
programs, one of high intensity and one of moderate intensity, can replace
medication as a treatment for mild essential hypertension, 2) determine if a
moderate intensity endurance training program is as effective as or more
effective than a high intensity program in allowing mild essential
hypertensives to discontinue anti-hypertensive medication, 3) determine if
physiological, psychological, and compliance variables predict success in
allowing mild essential hypertensives to discontinue anti-hypertensive
medication. The investigators propose a randomized controlled trial. Known
hypertensives (n=162) whose diastolic blood pressures rises to between 90
and 104 within four months of discontinuing medication under careful
observation will have their pressures controlled with enalapril. Half the
subjects will be female and half male, and their racial characteristics will
generally reflect that of our managed care population (about 20% black).
V02 peak will be measured during cycle ergometry. Eligible subjects will be
randomly assigned to 18 months participation in one of three groups: 1)
high intensity endurance training (35 minutes 3 times/week at heart rate at
70-85% of V02 peak), 2) moderate intensity endurance training (35 minutes 3
times/week at heart rate of 50-70 of V02 peak), and 3) contact control.
Enalapril will be forward or back titrated or discontinued to maintain a
normal blood pressure. After 12 months participation, medication will be
withdrawn under careful supervision from all subjects still taking it. They
will test the hypotheses that: 1) a greater number of subjects undergoing
either or both of the two 18 month exercise training programs will be able
to stop anti-hypertensive medication than non-exercising controls, 2)
moderate and high intensity endurance training are equally effective in
replacing drugs in the treatment of mild essential hypertension, and 3)
subjects that are successful at withdrawing anti-hypertensive medication
will have: greater improvements in V02 peak, better initial psychological
status or greater improvements in psychological status, and greater
compliance with the exercise training program. The investigators state that
this study will be a critical test of whether endurance training can replace
medication in an important number of patients as a treatment for
hypertension.
Public Health Relevance Statement
Data not available.
NIH Spending Category
No NIH Spending Category available.
Project Terms
aerobic exercisebehavioral /social science research tagblood chemistrybody physical activitycardiovascular stress testclinical researchclinical trialsdisease /disorder prevention /controldrug administration rate /durationessential hypertensionexercisegender differencehuman middle age (35-64)human subjecthuman therapy evaluationlongitudinal human studyoutcomes researchpatient care managementpsychological adaptationpsychological testsquestionnairesracial /ethnic differencetherapy compliance
No Sub Projects information available for 7R01HL056907-03
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