Aims: 

Life style changes including moderate exercise are recommended for hypertensive patients in the current guidelines. However, little data are available about the long-term effect of physical exercise in hypertensives in comparison to standard medication. The aim of this study was to compare the effects of conventional blood pressure reduction to the effect of physical exercise in hypertensive rats at advanced age and established hypertension and hypertrophy.

Methods: 

39 female spontaneously hypertensive rats were kept non-running for 12 months and then randomly subdived into 4 groups: non-running controls (Cont), non-running captopril treated animals (Cap), non-running hydralazine treated animals (Hy), and an exercise group with free access to voluntary running wheel exercise (Ex). Follow-up time was 6 months. All rats were controlled on a weekly basis.

Results: 

In the first 6 weeks, Ex resulted in an increase of the weekly running time and distance. Thereafter running time and distance remained constant. Cap and Hy reduced blood pressure to a similar extent. In both groups heart rate increased during the follow-up. Cap, but not Hy reduced left ventricular hypertrophy. Ex did not reduce Psyst and Pdiast but significantly reduced resting heart rate. However, this went along with an additional left ventricular hypertrophy, induction of right ventricular hypertrophy, signs of heart failure (increase in lung wet weight), and a higher mortality compared to the control groups.

Conclusion: 

Voluntary exerice produced the expected changes in resting heart rate but not in blood pressure. However, it further increases hypertrophy and mortality. Pharmacological reduction of blood pressure alone (Hy) is not sufficient to induce a reverse remodelling. However, ACE inhibition induced a reverse remodelling on top of blood pressure reduction. In conclusion, physical exercise of untrained hypertensives seems to represent a cardiac risk irrespectively of its effect on resting heart rate.