Hypertension and low physical activity place women at risk for long-term cardiovascular complications, yet these risks are modifiable through long-term adherence to an exercise training protocol. Research is lacking, in women with mild hypertension, on the effectiveness of exercise training in reducing blood pressure, and improving mood, a factor associated with long-term exercise adherence. Therefore, the specific aims of Phase I are to examine the effects of an aerobic exercise training protocol on resting blood pressure and mood in women with unmedicated mild hypertension using a two-group, repeated measures, experimental design. All subjects will undergo maximal exercise stress testing and random assignment to aerobic exercise training or the wait-list control group. An unanalyzed crossover arm will be included to allow control subjects equal accessibility to take part in exercise training. The exercise group will perform aerobic exercise, 3 times a week, up to 60 minutes a session, at 65% to 80% heart rate reserve, for 16 weeks. All subjects will undergo another exercise stress test at the sixteenth week. Resting blood pressure and mood will be measured at baseline, the twelfth week, and the sixteenth week; maximal oxygen consumption will be measured at baseline and the sixteenth week. For Phase II, the specific aims are to determine the effect of a 1-year home-based exercise protocol on resting SBP and DBP, and mood between the CDC/PACE counseling and the no counseling groups; determine the effect of CDC/PACE counseling on exercise adherence over a 1-year period, and examine variables predictive of long-term adherence. Phase II is a repeated measures, experimental design where those in the initial exercise group will be randomly assigned to either the CDC/PACE counseling or to the no counseling group. Both groups will visit the Center over a 1-year period for measurements of resting SBP and DBP, mood, and percent of adherence to exercise. Data will be analyzed using repeated measures ANOVA and ANCOVA. These interventions provide women with an opportunity to utilize relapse prevention strategies in order to maintain exercise and control their blood pressure.
