Effects of intense aerobic exercise and/or antihypertensive medication in individuals with metabolic syndrome

We studied the blood pressure lowering effects of a bout of exercise and/or antihypertensive medicine with the goal of studying if exercise could substitute or enhance pharmacologic hypertension treatment. Twenty-three hypertensive metabolic syndrome patients chronically medicated with angiotensin II receptor 1 blockade antihypertensive medicine underwent 24-hr monitoring in four separated days in a randomized order; (a) after taking their habitual dose of antihypertensive medicine (AHM trial), (b) substituting their medicine by placebo medicine (PLAC trial), (c) placebo medicine with a morning bout of intense aerobic exercise (PLAC+EXER trial) and (d) combining the exercise and antihypertensive medicine (AHM+EXER trial). We found that in trials with AHM subjects had lower plasma aldosterone/renin activity ratio evidencing treatment compliance. Before exercise, the trials with AHM displayed lower systolic (130 ± 16 vs 133 ± 15 mm Hg; P = .018) and mean blood pressures (94 ± 11 vs 96 ± 10 mm Hg; P = .036) than trials with placebo medication. Acutely (ie, 30 min after treatments) combining AHM+EXER lowered systolic blood pressure (SBP) below the effects of PLAC+EXER (-8.1 ± 1.6 vs -4.9 ± 1.5 mm Hg; P = .015). Twenty-four hour monitoring revealed no differences among trials in body motion. However, PLAC+EXER and AHM lowered SBP below PLAC during the first 10 hours, time at which PLAC+EXER effects faded out (ie, at 19 PM). Adding exercise to medication (ie, AHM+EXER) resulted in longer reductions in SBP than with exercise alone (PLAC+EXER). In summary, one bout of intense aerobic exercise in the morning cannot substitute the long-lasting effects of antihypertensive medicine in lowering blood pressure, but their combination is superior to exercise alone.