Failure of Exercise to Reduce Hypertension

To the Editor. —In their article entitled Failure of Exercise to Reduce Blood Pressure in Patients With Mild Hypertension, Blumenthal et al 1 suggested that aerobic exercise should not be considered a replacement for pharmacological therapy in patients with mild hypertension. Because their study did not compare exercising patients with patients taking antihypertensive medication, this conclusion is overstated. On the other hand, our study 2 of a similar group of patients with mild hypertension was a direct comparison of exercise training with concomitant use of propranolol hydrochloride, diltiazem hydrochloride, or placebo. Patients were randomized to drug therapy in a double-blinded manner. We found a mean blood pressure decrease from 145/97 to 133/84 mm Hg, with exercise training among all our patients. There were no differences among the drug or placebo groups in the magnitude of lowering blood pressure. As such, we concluded that patients who engage in exercise may not need