Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension: A randomized clinical trial

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Background: A single exercise session evokes immediate blood pressure (BP) reductions that persist for at least 24 h, termed postexercise hypotension (PEH). Self-monitoring of PEH may foster positive outcome expectations of exercise, and thus, enhance exercise adherence among adults with hypertension. Purpose: To compare the efficacy of self-monitoring of exercise (EXERCISE) versus exercise and PEH (EXERCISERPEH) to improve exercise adherence and BP control among adults with hypertension. Methods: Adults with high BP were randomized to EXERCISE (n=12) or EXERCISERPEH (n=12). Participants underwent supervised, moderate intensity aerobic exercise training for 40-50 min/session, 3 days/week for 12 weeks and encouraged to exercise unsupervised at home at least 30 min/day, 1-2 days/week. EXERCISERPEH also selfmonitored BP before and after exercise. Adherence was calculated as [(no. of exercise sessions performed/no. of possible exercise sessions)×100%]. BP was measured pre and posttraining. Results: Healthy, middle-aged (52.3±10.8 years) men (n=11) and women (n=13) with hypertension (136.2±10.7/85.2±8.9mmHg) completed exercise training with 87.9±12.1% adherence. EXERCISERPEH demonstrated greater adherence to supervised training (94.3±6.6%) than EXERCISE (81.6±13.2%; P=0.007). EXERCISERPEH performed 32.6±22.5 min/week more unsupervised home exercise than EXERCISE (P=0.004), resulting in greater exercise adherence (107.3±18.7%) than EXERCISE (82.7±12.2%; P=0.002). Post versus pretraining BP was reduced -7.4±11.3/-4.9±9.9mmHg (P<0.025) with no statistical difference between EXERCISE (-5.2±13.3/-3.6±6.1mmHg) and EXERCISERPEH (-9.9±11.3/-6.1±6.9mmHg; P>0.344). Conclusion: The current study is the first to demonstrate that PEH self-monitoring is an efficacious tool to improve exercise adherence among a small sample of adults with hypertension. Future research among a larger, more diverse sample is needed to confirm these novel findings and determine whether EXERCISERPEH translates to better BP control relative to EXERCISE self-monitoring alone.

Publication Title

Journal of Hypertension