June 16, 2007 – Milan, Italy – In elderly patients with hypertension, endurance training provided similar cardiovascular benefits in the presence or absence of beta-blockers (BB). Measurement of lactate in capillary blood was used to determine the target exercise heart rate for each patient in the exercise group, in what appears to be the first time this lactase-based training approach has been used in such a study. Exercise training prescriptions are usually based on heart rate. The results of this study were presented by Prof. T. Westhoff, Berlin, Germany, at the 17th European Meeting on Hypertension, held in Milan from July 15-19, 2007.

In this randomized controlled trial, 52 patients (mean age 67 years) with hypertension (systolic ambulatory blood pressure >/=140 mmHg and/or antihypertensive drug) were randomized to either a BB (n=23) or no BB (n=29) and to either sedentary activity (n=25) or heart-rate controlled treadmill walking (n=27). The treadmill exercise was performed for 30-45 minutes, 3 times per week for 12 weeks.

In the exercise group, a significant reduction of -10.6/-5.8 mmHg in systolic and diastolic ambulatory blood pressure (ABP) was found, while no change was seen in the control group, showing that the training concept was effective, Westhoff stated. The presence or absence of BB did not affect the achieved blood pressure level (-10.6 mmHg systolic ABP ±; -5.7 mmHg and -5.8 mmHg diastolic ABP with and without BB, respectively). The BB used and its dose was different in the patients.

The mean training heart rate was significantly lower by about 20% with a BB (97.2 bpm, vs 118.3 bpm without a BB; p<0.001). In the exercise group, there was also a significant reduction in blood pressure on exertion, possibly mediated by endothelial vasodilation. Improvements in endothelium-dependent vasodilation and physical performance were found with exercise, with or without BB.