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Antihypertension medications more effective than exercise at lowering systolic BP

Across all populations, patients who only received antihypertension medications had greater systolic BP reductions than those who only engaged in structured exercise regimens.

Also, in patients with hypertension, medications and certain exercise regimens had the same impact on the patient’s systolic BP.

Both results stem from a meta-analysis recently published in the British Journal of Sports Medicine.

New guidelines will likely increase the number of patients diagnosed with hypertension, Huseyin Naci, PhD, MHS, of the department of health policy at London School of Economics and Political Science, and colleagues wrote, adding that “recent increases in medication-related costs have prompted significant policy and clinical attention to the comparative effectiveness of new and existing medications.”

They added the impact of nonpharmacological interventions such as exercise have not been widely researched.

Naci and colleagues analyzed 194 randomized clinical trials with 29,281 participants that evaluated antihypertensive medications and 197 randomized clinical trials with 10,461 participants that evaluated exercise interventions. Only 56 exercise-based trials included participants with hypertension.

Researchers found:

• Among all populations, patients that received antihypertensive medications had higher reductions in baseline systolic BP vs. patients in structured exercise interventions;
• All exercise types and all classes of antihypertensive medications lowered baseline systolic BP vs. controls;
• Among patients with hypertension, ACE inhibitors, angiotensin-2 receptor blockers, beta-blockers and diuretic medications yielded no difference in systolic BP vs. endurance or dynamic resistance exercise.

“Our findings can form the basis of evidence-based discussions between patients and their doctors about the systolic BP-lowering benefits of exercise,” Naci and colleagues wrote.

“Although the effect of exercise is modest among individuals with moderately elevated systolic BP, providers should still have such discussions with their patients who are newly eligible for antihypertensive therapy as a result of recent changes to the [American Heart Association/American College of Cardiology] guidelines,” they added. – by Janel Miller

Disclosures : The authors report no conflicts of interest.