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Walking Equals Effects Of A Diuretic In Preventing High BP & Enlarged Heart

Posted: Tuesday, July 13, 2004

Only recently was a type of diuretic known as thiazides been found to be superior to angiotensin-converting enzyme (ACE) inhibitors and calcium antagonists (calcium channel blockers) in preventing one or more major types of cardiovascular disease. The diuretics also tend to have fewer and less severe side effects, making it easier to stay on medication. In addition, the diuretics are relatively inexpensive. Exercise has always been recommended for good cardiac health.

So what should the at-risk, older American do to sustain good cardiac health?

Since endurance exercise training improves increased levels of insulin in the plasma and insulin resistance it is possible that the benefits leading to increase in cardiac health may occur because insulin is a stimulus for the development of an enlarged heart.

This study focused on the left ventricle relative wall thickness in addition to left ventricle mass because in hypertension LV remodeling appears to be as good or even better predictor of LV dysfunction and cardiac risk factor than LVH.

The findings of this study suggest that a program of mild-to-moderate intensity exercise training can result in partial regression of increased LV relative wall thickness and LVH that is similar to the effect induced by a thiazide diuretic. Although hydrochlorothiazide is considerably more effective in reducing systolic blood pressure than exercise, metabolic adaptations that occur only with exercise training can provide significant additional clinical benefits that are not attainable with a thiazide diuretic.

Therefore, endurance exercise training appears to be a suitable treatment strategy in some older adults with mild hypertension because despite a smaller decrease in blood pressure, it can induce a comparable regression of cardiac mass with improvements in insulin resistance and aerobic capacity and because aggressive reduction of blood pressure by antihypertensive medications may not necessarily confer a greater protection against the risk of death in hypertensive elderly patients.

The authors of “Comparison of the Effects of Exercise and Diuretic on Left Ventricular Geometry, Mass, and Insulin Resistance in Older Hypertensive Adults, are Morton R. Rinder, Robert J. Spina, Linda R. Peterson, Christopher J. Koenig, Christa R. Florence, and Ali A. Ehsani, all from the Washington University School of Medicine, St. Louis, MO. Their findings are published in the online edition of the American Journal of Physiology – Regulatory, Integrativ and Comparative Physiology. (www.the-aps.org).

Source: Diabetes In Control.com