Physical activity recommendation for hypertension management: does healthcare provider advice make a difference?

BACKGROUND Achieving normal blood pressure with antihypertensive medication remains an achievable goal for only approximately equal to 31% of hypertensive patients. Physical activity is a primary lifestyle measure required to lower blood pressure in hypertensive patients, and the US Preventative Services Task force (USPSTF) recommends counseling by health care providers to promote regular physical activity. Surveys of patients suggest, however, that few healthcare providers follow the USPSTF recommendation on physical activity counseling. METHOD This article examined data on the rate of healthcare provider counseling, compliance with recommendations and the blood pressure difference associated with following recommendations to increase physical activity. Data are from the National Health and Nutritional Examination Survey III 1988-1994 (NHANES-III) of adults with hypertension. We compared the results of compliance with recommendation from the NHANES-III data to five recent clinical trials on physical activity conducted between 1991 and 2001. RESULTS A third of the NHANES-III hypertensive patients received counseling to engage in physical activity to manage their hypertension, and 71% (n=669) followed the recommendations and had a systolic blood pressure that was an average of approximately equal to 3-4 mm Hg lower than those who did not follow recommendations. CONCLUSION This study shows that fewer patients are receiving exercise counseling to help lower blood pressure and improve health outcomes. However, patients seem to follow the advice when given. Given the magnitude of poorly controlled hypertension, these findings should alert healthcare providers to find innovative means of physical activity recommendation to improve health outcomes.