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Seniors Shouldn't Fear Exercise, Study Finds

July 28, 2006

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A Johns Hopkins study should ease older adults' concern that exercise could harm their hearts, even if they have mild high blood pressure.

Results of the research on 104 men and women age 55 to 75 showed that a moderate program of physical exertion had no ill effects on the heart's ability to pump blood nor does it produce a harmful increase in heart size.

In this study, "moderate" translated to sustained exercise for about an hour, three times a week. Researchers say people's concerns stem from the fact that during each workout, blood pressure can on average rise from 40 millimeters to 60 millimeters of mercury.

"While having high blood pressure at rest is a well-established risk factor for heart problems, older people should not fear the effects of moderate exercise on the heart, despite short-term bump-ups in blood pressure during their workout," said lead study investigator and exercise physiologist Kerry Stewart, Ed.D., a professor of medicine and director of clinical and research exercise physiology at The Johns Hopkins University School of Medicine and its Heart Institute.

"Exercise is a highly effective means of increasing the heart's efficiency and reducing body fat, factors that may ward off future health problems, such as heart disease and diabetes," he noted.

A report on the Hopkins study, published in the July issue of the journal Heart, showed that after six months of aerobic exercise on a treadmill, bicycle or stepper, plus weightlifting, participants showed no overall ill effects in 11 measures of diastolic heart function, when the organ's main chamber fills with blood between beats.

They study found that exercise produced no increase in eight measures of heart size. In contrast, a long-term effect of hypertension, even when the body is relaxed, is hypertrophy, an enlargement of the heart that eventually stiffens and weakens the muscle.

Not only were there no ill effects sustained, despite periodic increases in blood pressure during the workout, Stewart and his team reported, but results also suggest that the exercise producing these effects benefited the hearts of those who made the most gains in physical fitness and for those who lost the most abdominal fat.

And, researchers say, unlike the increased heart size that results from high blood pressure, any increase in heart size observed in the active group was similar to what athletes experience when their hearts get bigger and stronger, not stiff.

For a six-month period, the Hopkins team assessed the benefits of a supervised program of exercise training in a group of 104 older men and women, measuring heart function, and body fitness and fat levels at the start and end of the study.

All of the participants were in general good health except for untreated, mild hypertension. Half were randomly placed in a widely recommended moderate exercise program while the rest maintained their usual physical routine and diet.

The active group participated in a supervised series of exercises for 60 minutes, three times per week. The combination of exercises was designed to work all major muscle groups, including the heart, with substantial improvements observed in active participants' body fat, and muscle and fitness levels.

Aerobic fitness, as measured by peak oxygen uptake on a treadmill, increased by 17 percent , as did average strength. The average weight loss in this group was only four pounds, because much of the loss of fat was offset by increased muscle mass.

The fat in the abdominal region, measured by magnetic resonance imaging, was reduced by 20 percent among exercisers. The group that was not exercising had either no or significantly less improvement than the exercising group. Special scans, using an X-ray machine, were used to assess total body fat.

"Making gains in body fitness and losing abdominal fat are truly important to the long-term health of the heart," said study co-author and cardiologist Edward Shapiro, M.D., a professor at Hopkins. "Our results confirm that moderate-intensity exercise can have many health benefits -- including gains in heart function that are linked to increased fitness and reduced fatness.

"Our study also shows that the vast majority of older people with mildly elevated blood pressure can benefit from moderate exercise, and they should talk about it with their physician to determine an appropriate exercise and any other options for treatment."

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