Role of Physical Activity, Exercise, and Cardiorespiratory Fitness in the Management of Resistant Hypertension

  • Puneet Narayan
  • Anubhav Kumar


Resistant hypertension (HTN) is defined as uncontrolled blood pressure ≥ 130/80 mm Hg despite treatment with adequate dosages of three or more antihypertensive medications, one of which is a diuretic or requiring a regimen of four or more medications for control. As is evident from the definition, controlling blood pressure is a challenge in this population. This lack of blood pressure control puts these patients at additional cardiovascular risk compared to the nonresistant hypertensive populations. It is well known and established that lowering blood pressure translates in lower risk of cardiovascular morbidity and mortality and is the cornerstone of the management of HTN. It is thus concerning that blood pressure-lowering trials in patients with resistant HTN have not uniformly translated in improved outcomes. This chapter will encompass definition of resistant HTN and factors that make blood pressure more resistant to treatment, together with the role of physical fitness, exercise, and cardiorespiratory fitness on lowering blood pressure, morbidity, and mortality in this subgroup of hypertensives.


Resistant hypertension Cardiorespiratory fitness Physical activity Exercise Mortality HTN 



Ambulatory blood pressure monitor


Blood pressure


Chronic kidney disease


Cardiorespiratory fitness


Cardiovascular disease


Type 2 diabetes mellitus


Exercise tolerance test


High-intensity interval training


High-sensitivity C-reactive protein




Left ventricular hypertrophy


Metabolic equivalents


Obstructive sleep apnea


Physical activity


Pulse wave velocity


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Puneet Narayan
    • 1
  • Anubhav Kumar
    • 1
  1. 1.Clinical Research Institute of Northern VirginiaBurkeUSA

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