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A novel 4 pillar model of exercise delivery further reduces blood pressure in hypertensive individuals

Session Moderated poster session - Public health and cardiac rehabilitation


Event : EuroHeartCare 2019

  • Topic : hypertension
  • Sub-topic : Hypertension - Treatment
  • Session type : Moderated Posters

Authors : G Kandola (London,GB), Y Rumble (London,GB), M Thompson (London,GB), S Olden (London,GB), I Cradock (London,GB)

G Kandola1 , Y Rumble1 , M Thompson1 , S Olden1 , I Cradock1 , 1Clinical Prevention and Rehabilitation - London - United Kingdom of Great Britain & Northern Ireland ,


Hypertension  is one of the leading causes of premature death and disability, accounting for 9.4 million deaths yearly worldwide (WHO 2013). Research has found every 10mmHg reduction in systolic blood pressure (SBP) reduces the risk of major cardiovascular events, such as heart disease and strokes and leads to a 13% reduction in mortality rate (Ettehad et al. 2016). Despite this statistic, 1 in 3 diagnosed with hypertension are not treated to target in the UK (British Heart Foundation, 2016). Exercise and lifestyle interventions have been proposed as a complementary addition to standard pharmacological care. This current study investigates the effectiveness of a novel 4 Pillar model of exercise delivery and nutritional guidance on reducing blood pressure in a hypertensive population.

150 participants (119M, 31F), aged 56.5 ± 10.5 years were included in the study if they either had an SBP >140 mmHg and/or diastolic blood pressure (DBP) >90 mmHg and/or were on anti-hypertensive medication. All participants completed a 12-week cardiac rehabilitation programme at CP+R. This involved twice-weekly supervised resistance sessions reaching overload, twice-weekly aerobic training within a prescribed heart rate zone, on-going step-count monitoring and nutritional guidance. The programme was led by a clinical exercise specialist and overseen by a clinical nurse. Participants underwent pre and post measures of SBP and DBP, recorded manually using an aneroid sphygmomanometer. 

SBP and DBP decreased from 134.3/83.9 mmHg to 124.0/77.8 mmHg, showing significant reductions in SBP 10.3 ± 11.7 mmHg and DBP 6.1 ± 9.1 mmHg (both P<0.05). 

A novel exercise and nutrition programme incorporating a 4 Pillar model significantly reduced SBP and DBP in hypertensive patients and those already on pharmacological treatment. This could provide a blueprint for an effective application of lifestyle intervention following primary care that should be routinely offered to individuals to further reduce risk of cardiovascular events and mortality.

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