Can hypertensive patients safely benefit from exercise?

DOCTORS are usually wary of advising patients with pulmonary hypertension to exercise for fear that it may put too much extra strain on the heart. However, a new review suggests patients with the condition can benefit safely from exercise and improve their quality of life.

Pulmonary hypertension is where there is high blood pressure in the arteries between the heart and the lungs. People with the condition find it hard to breathe, get tired easily and have dizzy spells.

In the United States (U.S.), estimates suggest pulmonary hypertension affects around 10 to15 people per million of the population. Left untreated, the condition can lead to heart failure.

Cardiologists from the University of Texas Southwestern Medical Center, Dallas, report in the journal Circulation: Heart Failure how they pooled and analyzed data on over 400 participants taking part in different studies.

The analysis shows that exercise training can reduce blood pressure in the arteries affected by pulmonary hypertension and increase exercise tolerance without compromising safety.

Senior author Jarett Berry, associate professor of internal medicine and clinical sciences, says their findings suggest the traditional skepticism of doctors about suggesting exercise for patients with pulmonary hypertension may be misplaced.

“More importantly, exercise had a positive effect on several measures of heart function as well as overall quality of life,” he adds.

The team reviewed 16 studies covering a total of 434 participants with pulmonary hypertension. The pooled analysis found exercise training was linked to a significant improvement in six-minute walking distance, peak oxygen uptake, arterial blood pressure, peak exercise rate and quality of life measures.
Study authors recommend patients discuss exercise with their doctors

The authors also note that “exercise training was well tolerated with a low dropout rate and no major adverse events related to exercise training,” and conclude: “Exercise training in patients with pulmonary hypertension appears safe and is associated with a significant improvement in exercise capacity, pulmonary arterial pressure and quality of life.”

However, the authors are not suggesting people with pulmonary hypertension should now start vigorous cycling or jogging.