Exercise and hypertension. Maximizing the benefits in patients receiving drug therapy.

Aerobic exercise may prevent hypertension and reduce blood pressure and mortality in hypertensive patients and those at high risk for coronary artery disease. Supervised aerobic exercise at an intensity of 70% to 80% of maximal aerobic capacity is recommended to achieve cardiovascular conditioning and other health benefits. When antihypertensive drug therapy is required, physicians should choose an agent that has favorable secondary effects, including hemodynamic responses to exercise. The most favorable effects are achieved with calcium channel blockers, angiotensin-converting enzyme inhibitors, alpha blockers, and central alpha agonists. The effects of diuretics are less desirable, and beta blockers should be a last choice for hypertensive patients who are physically active.