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—The purpose of this  study was to determine the effects of exercise and weight loss on  cardiovascular responses during mental stress in mildly  to moderately overweight patients with elevated blood pressure.  Ninety-nine men and women with high normal or unmedicated stage 1 to  stage 2 hypertension (systolic blood pressure 130 to 179  mm Hg, diastolic blood pressure 85 to 109 mm Hg)  underwent a battery of mental stress tests, including simulated public  speaking, anger recall interview, mirror trace, and cold pressor,  before and after a 6-month treatment program. Subjects were randomly  assigned to 1 of 3 treatments: (1) aerobic exercise, (2) weight  management combining aerobic exercise with a behavioral weight loss  program, or (3) waiting list control group. After 6 months, compared  with control subjects, participants in both active treatment groups had  lower levels of systolic blood pressure, diastolic  blood pressure, total peripheral resistance, and heart rate  at rest and during mental stress. Compared with subjects in the control  group, subjects in the exercise and weight management groups also had  greater resting stroke volume and cardiac output. Diastolic  blood pressure was lower for the weight management group than for the  exercise-only group during all mental stress tasks. These results  demonstrate that exercise, particularly when combined with a weight  loss program, can lower both resting and stress-induced blood pressure  levels and produce a favorable hemodynamic pattern  resembling that targeted for antihypertensive therapy.

Effects of Exercise and Weight Loss on Mental Stress–Induced Cardiovascular Responses in Individuals With High Blood Pressure