Lifestyle and Exercise Intervention Reduces Blood Pressure: A Multiethnic Control Trial

Abstract

The effect of ethnicity and medication on blood pressure (BP) have been widely described; however, less is known about the interaction between ethnicity, BP medication and regular exercise on hypertensive patients. PURPOSE: This study was aimed to determine the effectiveness of an exercise training and healthy lifestyle education program to reduce BP levels and improve adherence to pharmacological therapy on a multiethnic group of hypertensive patients. METHODS: An 8-month quasi-experimental longitudinal intervention with an exercise group (EG) and control group (CG) was designed. Five hundred and sixty-eight hypertensive patients (67.4±8.8 years; BMI, 26.4±3.1 kg/m2; systolic BP (SBP), 146±9 mmHg and diastolic BP (DBP), 95±7 mmHg; 18% Indigenous, 23% Colombian-African and 59% Hispanic) finalized the study (EG, n= 307 and CG, n= 261). EG participated in 3 weekly exercise training sessions (30 to 60 minutes of concurrent training), which were complemented by medication and lifestyle education. The average of three repeated measures of BP performed with an electronic sphygmomanometer was utilized as primary outcome. Health status, medication adherence, salt consumption, tobacco and alcoholic habits were recorded by questionnaires during clinic history assessment. Non-parametric tests were carried out to compare differences between EG and CG. Several logistic regression models were used to find independent variables predicting two levels (-3 or - 5 mmHg) of reduction in systolic (SBP) or diastolic blood pressures (DBP). RESULTS: We found significant reductions both SBP and DBP in EG (-5.92 mmHg and -5.0 mmHg, respectively, P<0.001 for both) but not in the CG. Also, prevalence of medication adherence was significantly improved in 28.7% (P<0.001) in the EG. In the logistic regression, all models confirmed the EG as the main explanatory variable of a 3 or 5 mmHg BP reduction, independently of other lifestyle risk factors and medication adherence. CONCLUSIONS: In accordance with other studies patients in EG showed more diminution in SBP and DBP than CG, which was independent of other risks factors. However, the main findings were that either ethnic or medication adherence did not influence statistically the reduction in BP associated with our exercise/lifestyle intervention.