Exercise interventions for older adults with high blood pressure: From efficacy to adherence

This paper reviews studies on the effects of aerobic exercise upon blood pressure in older hypertensives. Controlled evaluations indicate average decreases in systolic and diastolic resting blood pressure of 8.8 mm Hg systolic and 7.8 mm Hg, respectively, indicating a moderate, yet clinically important reduction. However, few studies have independently focused on the older adult hypertensive, an increasingly important source of cardiovascular morbidity, mortality, and costly health care utilization. Still fewer studies address the critically related problem of adherence, including the demonstration of efficacious methods of enhancing adherence to exercise with this population. Some factors associated with higher exercise adherence rates in the older adult include participation in low-intensity exercise that is perceived as reinforcing and safe. Research also indicates the potential value of home-based exercise programs in promoting compliance to the regimen. Several suggestions for further research are offered including the necessity for larger scale studies to establish the short and long-term efficacy of exercise on reducing blood pressure and overall cardiovascular risk reduction, especially in those most likely to experience costly cardiovascular endpoints, such as hypertensives over 60, as well as middle- aged to older individuals of African heritage.