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Physical activity in the prevention and treatment of hypertension in the obese


Medicine & Science in Sports & Exercise: November 1999 - Volume 31 - Issue 11 - p S624
Roundtable Consensus Statement

FAGARD, R. H. Physical activity in the prevention and treatment of hypertension in the obese. Med. Sci. Sports Exerc., Vol. 31, No. 11, Suppl., pp. S624–S630, 1999.

Purpose The purpose of this paper was to assess the value of physical exercise in the prevention and treatment of hypertension with particular attention to possible interactions with relative weight.

Methods We describe epidemiological studies and report meta-analyses of randomized intervention trials, i.e., randomized controlled trials on dynamic physical training and randomized comparative trials of exercise and diet.

Results Epidemiological studies show an inverse relationship between physical activity or fitness and the incidence of hypertension, which was either independent of body size or more pronounced in the overweight. The weighted net reduction of blood pressure in response to dynamic physical training averages 3.4/2.4 mm Hg (P < 0.001), which appears to be unrelated to the initial body mass index ( BMI) and to its training-induced changes. Exercise is less effective than diet in lowering blood pressure (P < 0.02), and adding exercise to diet does not appear to further reduce blood pressure. Future studies should observe scientific criteria more strictly, address the truly obese (BMI ≥ 30 kg·m−2) and attempt to resolve the blood pressure lowering mechanisms.

Conclusion Physical activity contributes to the control of blood pressure in overweight as well as in lean subjects.

Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, Faculty of Medicine, University of Leuven, Leuven, BELGIUM

Address for correspondence: R. Fagard, M.D., Ph.D., Prof. of Medicine, U.Z. Gasthuisberg-Hypertensie, Herestraat 49, B-3000 Leuven, Belgium. E-mail: robert.fagard@

Roundtable held February 4–7, 1999, Indianapolis, IN.

© 1999 Lippincott Williams & Wilkins, Inc.