Hypertension is a major cardiovascular disorder affecting 18% of the adult population in the United States. The goal of antihypertensive therapy is to minimize end-organ damage that can lead to kidney failure, stroke, and coronary heart disease. In addition, hypertension itself has been shown to be associated with impaired psychological functioning that may be reversed with blood pressure normalization. The present study is designed to test the hypothesis that chronic aerobic exercise will reduce blood pressure and improve quality of life in hypertensive men and women. One hundred twenty men and women with mild hypertension and 40 normotensive controls will serve as subjects for this study. First, the cognitive performance of hypertensives and normotensives will be compared. Second, hypertensive subjects will be randomly assigned to an aerobic exercise program, to a toning and flexibility group, or to a waiting list control group. Upon entry and after four months, subjects will undergo comprehensive evaluations including blood chemistries, symptom-limited treadmill testing, ambulatory blood pressure monitoring, and cognitive and psychometric testing. Subjects also will undergo a behavioral challenge to assess cardiovascular and neuroendocrine responsivity. We hypothesize that a program of regular exercise will attenuate cardiovascular and neuroendocrine responsivity, reduce blood pressure as measured in the laboratory and in the natural environment, and improve cognitive functioning. We will also examine the role of individual differences in responses to exercise training, including considerations of ethnicity and sympathetic nervous system tone. This project has important scientific significance by proposing to systematically evaluate the effects of aerobic exercise on blood pressure in patients with mild hypertension. The study also has important practical significance by evaluating the efficacy of non-pharmacologic management of hypertension. If successful, aerobic exercise could be implemented as a cost-effective strategy for reducing the physical, psychological, and economic costs associated with hypertension.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL030675-06
Application #
3341709
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1985-01-01
Project End
1992-09-30
Budget Start
1990-04-15
Budget End
1992-09-30
Support Year
6
Fiscal Year
1990
Total Cost
Indirect Cost
Name
Duke University
Department
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Madden, D J; Blumenthal, J A (1998) Interaction of hypertension and age in visual selective attention performance. Health Psychol 17:76-83
Burker, E J; Blumenthal, J A; Feldman, M et al. (1995) The Mini Mental State Exam as a predictor of neuropsychological functioning after cardiac surgery. Int J Psychiatry Med 25:263-76
Thyrum, E T; Blumenthal, J A; Madden, D J et al. (1995) Family history of hypertension influences neurobehavioral function in hypertensive patients. Psychosom Med 57:496-500
Burker, E J; Blumenthal, J A; Feldman, M et al. (1995) Depression in male and female patients undergoing cardiac surgery. Br J Clin Psychol 34 ( Pt 1):119-28
Burker, E J; Fredrikson, M; Rifai, N et al. (1994) Serum lipids, neuroendocrine, and cardiovascular responses to stress in men and women with mild hypertension. Behav Med 19:155-61
Hamer, M E; Blumenthal, J A; McCarthy, E A et al. (1994) Quality-of-life assessment in patients with paroxysmal atrial fibrillation or paroxysmal supraventricular tachycardia. Am J Cardiol 74:826-9
Blumenthal, J A; Wei, J (1993) Psychobehavioral treatment in cardiac rehabilitation. Cardiol Clin 11:323-31
Blumenthal, J A; Madden, D J; Pierce, T W et al. (1993) Hypertension affects neurobehavioral functioning. Psychosom Med 55:44-50
Steege, J F; Blumenthal, J A (1993) The effects of aerobic exercise on premenstrual symptoms in middle-aged women: a preliminary study. J Psychosom Res 37:127-33
Pierce, T W; Madden, D J; Siegel, W C et al. (1993) Effects of aerobic exercise on cognitive and psychosocial functioning in patients with mild hypertension. Health Psychol 12:286-91

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