“Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0

Exercise Training Can Provide Meaningful Blood Pressure Improvement

MedicalResearch.com Interview with:

Fernando Ribeiro

Dr. Ribeiro

Fernando Ribeiro PhD
School of Health Sciences
Institute of Biomedicine – iBiMED
University of Aveiro
Aveiro, Portugal

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Resistant hypertension is a puzzling problem without a clear solution. The available treatment options to lower blood pressure, namely medication and renal denervation, have had limited success, making nonpharmacological strategies good candidates to optimize the treatment of this condition.

Exercise training is consistently recommended as adjuvant therapy for patients with hypertension, yet, it is with a great delay that the efficacy of exercise training is being tested in patients with resistant hypertension.

Having that in mind, the EnRicH trial was designed to address whether the benefits of an exercise intervention with proven results in hypertensive individuals are extended to patients with resistant hypertension, a clinical population with low responsiveness to drug therapy. Exercise training was safe and associated with a significant and clinically relevant reduction in 24-hour, daytime ambulatory, and office blood pressure compared with control (usual care).

MedicalResearch.com: What should readers take away from your report?

Response: I would emphasize a couple of points. Exercise-induced reductions in blood pressure occurred:

1) After a rigorous blood pressure assessment protocol,

2) After a similar standardized antihypertensive treatment strategy in both exercise and control groups,

3) With the assessment of antihypertensive treatment compliance, and

4) After a standardized aerobic exercise prescription.

Also, the exercise intervention is easy to replicate with minimum need for equipment. So, I truly believe clinical translation is a strong point of our results.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: To help clinicians making specific long-term exercise recommendations for this patient population, we need to implement this exercise intervention on a larger scale, perhaps moving to an unsupervised, home-based setting to overcome some of the logistical barriers (eg, transportation and scheduling barriers) that patients in supervised programs face.

Further research should also focus on investigating why some patients are non-responders to the exercise intervention.

MedicalResearch.com: Is there anything else you would like to add?

Response: I would like to highlight that the exercise training intervention tested in the EnRicH trial is inexpensive and accessible for the great majority of patients and easy to prescribe by physicians with different backgrounds, e.g. primary care, internal medicine, cardiology, or other health care professionals.

It may not work in all patients, as we’ve seen in our study, but it holds the potential to promote clinically significant results in the great majority of them.


Lopes S, Mesquita-Bastos J, Garcia C, Bertoquini S, Ribau V, Teixeira M, Ribeiro IP, Melo JB, Oliveira J, Figueiredo D, Guimarães GV, Pescatello LS, Polonia J, Alves AJ, Ribeiro F. Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial. JAMA Cardiol. 2021 Aug 4. doi: 10.1001/jamacardio.2021.2735. Epub ahead of print. PMID: 34347008.



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Last Updated on August 5, 2021 by Marie Benz MD FAAD