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Randomized, well-controlled exercise intervention studies have shown consistently that regularly performed aerobic exercise significantly lowers blood pressure in patients with essential hypertension. Mild to moderate intensity exercise may be more effective in lowering blood pressure than higher intensity exercises. Such exercise is also safe and effective in lowering blood pressure in treated patients with severe hypertension and left ventricular hypertrophy. A significant reduction in blood pressure and regression of left ventricular hypertrophy may be achieved in these patients even after substantial reductions in antihypertensive medication. Recent findings have also shown that exercise training attenuates exaggerated blood pressure response during physical exertion. The safety and efficacy of mild to moderate exercise has significant and positive clinical implications for all hypertensive patients. Exercise-induced reductions in resting blood pressure and prevention of abnormal increases in blood pressure during physical exertion can lead to fewer cardiovascular events. They may also reduce antihypertensive medication requirements, cost, and medication-related side-effects, and improve quality of life.