Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension: A randomized clinical trial
Date of Original Version
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.
Journal of Hypertension
Zaleski, Amanda L., Beth A. Taylor, Crystal L. Park, Lucas P. Santos, Gregory Panza, Melody Kramarz, Kyle McCormick, Paul D. Thompson, Antonio B. Fernandez, Ming Hui Chen, Bryan Blissmer, Kim M. Gans, and Linda S. Pescatello. "Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension: A randomized clinical trial." Journal of Hypertension 37, 9 (2019): 1877-1888. doi:10.1097/HJH.0000000000002115.