{"id":"717f7895219c","type":"article","url":"https://hartvaat.nl/2021/11/01/inspanningstraining-en-ambulante-bloeddruk-bij-resistente-hypertensie-jama-cardi/","title":"Inspanningstraining en ambulante bloeddruk bij resistente hypertensie: JAMA Cardiology","title_en":"Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts"],"tags":["ambulante-bloeddrukmeting","aperitif-trial","aprocitentan","bax24-trial","bloeddrukbehandeling","obesitas","select-trial","summit-trial"],"journal":"JAMA cardiology","doi":"10.1001/jamacardio.2021.2735","source_url":"https://doi.org/10.1001/jamacardio.2021.2735","authors":["Susana Lopes","José Mesquita-Bastos","Catarina Garcia","Susana Bertoquini","Verónica Ribau","Manuel Teixeira","Ilda P Ribeiro","Joana B Melo","José Oliveira","Daniela Figueiredo","Guilherme V Guimarães","Linda S Pescatello","Jorge Polonia","Alberto J Alves","Fernando Ribeiro"],"significance":7,"published":"2021-11-01","source_date":"2021-11-01","image":"","kennis":[],"congress":"","summary_en":"This randomized trial showed that structured aerobic exercise training significantly reduces ambulatory blood pressure in patients with resistant hypertension, supporting exercise as an important adjunctive strategy even when blood pressure is difficult to control pharmacologically.","created":"2026-07-03T10:29:28Z","updated":"2026-07-03T18:38:50Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"JAMA Cardiology gerandomiseerde trial van inspanningstraining op ambulante bloeddruk bij resistente hypertensie.","abstract_original":"IMPORTANCE: Limited evidence suggests exercise reduces blood pressure (BP) in individuals with resistant hypertension, a clinical population with low responsiveness to drug therapy. OBJECTIVE: To determine whether an aerobic exercise training intervention reduces ambulatory BP among patients with resistant hypertension. DESIGN, SETTINGS, AND PARTICIPANTS: The Exercise Training in the Treatment of Resistant Hypertension (EnRicH) trial is a prospective, 2-center, single-blinded randomized clinical trial performed at 2 hospital centers in Portugal from March 2017 to December 2019. A total of 60 patients with a diagnosis of resistant hypertension aged 40 to 75 years were prospectively enrolled and observed at the hospitals' hypertension outpatient clinic. INTERVENTIONS: Patients were randomly assigned in a 1:1 ratio to a 12-week moderate-intensity aerobic exercise training program (exercise group) or a usual care control group. The exercise group performed three 40-minute supervised sessions per week in addition to usual care. MAIN OUTCOMES AND MEASURES: The powered primary efficacy measure was 24-hour ambulatory systolic BP change from baseline. Secondary outcomes included daytime and nighttime ambulatory BP, office BP, and cardiorespiratory fitness. RESULTS: A total of 53 patients completed the study, including 26 in the exercise group and 27 in the control group. Of these, 24 (45%) were women, and the mean (SD) age was 60.1 (8.7) years. Compared with the control group, among those in the exercise group, 24-hour ambulatory systolic BP was reduced by 7.1 mm Hg (95% CI, -12.8 to -1.4; P = .02). Additionally, 24-hour ambulatory diastolic BP (-5.1 mm Hg; 95% CI, -7.9 to -2.3; P = .001), daytime systolic BP (-8.4 mm Hg; 95% CI, -14.3 to -2.5; P = .006), and daytime diastolic BP (-5.7 mm Hg; 95% CI, -9.0 to -2.4; P = .001) were reduced in the exercise group compared with the control group. Office systolic BP (-10.0 mm Hg; 95% CI, -17.6 to -2.5; P = .01) and cardiorespiratory fitness (5.05 mL/kg per minute of oxygen consumption; 95% CI, 3.5 to 6.6; P < .001) also improved in the exercise group compared with the control group. CONCLUSIONS AND RELEVANCE: A 12-week aerobic exercise program reduced 24-hour and daytime ambulatory BP as well as office systolic BP in patients with resistant hypertension. These findings provide clinicians with evidence to embrace moderate-intensity aerobic exercise as a standard coadjutant therapy targeting this patient population. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03090529."}