For people with high blood pressure, exercise can be the most important lifestyle change they can make, researchers say.

Yet two-thirds of doctors don’t take the time to tell their patients with high blood pressure about the importance of exercise and physical activity, a new study finds.

“Patients do follow physician recommendations to exercise when instructed to, and patients who follow exercise recommendations tend to have lower systolic blood pressures than those who do not,” said lead researcher Dr. Josiah Halm, a hypertension specialist at the University of Wisconsin School of Medicine and Public Health.

The findings are published in the summer issue of Ethnicity & Disease.

For the study, Halm’s team collected data on 17,474 people who participated in the Third National Health and Nutrition Examination Survey. Among these people, 4,686 reported having high blood pressure.

The researchers found that only slightly more than one-third of the people with high blood pressure said their doctor had told them to increase physical activity as a way of bringing down their blood pressure.

Yet, 71 percent of patients with high blood pressure saw a drop in their blood pressure when they increased their physical activity, which means that they listened when doctors told them to exercise more, according to the report.

“Non-pharmacological methods such as exercising are important in improving blood pressure control on a population level as this study looked at the cross-section of the U.S. population,” Halm said.

Studies have shown that small changes in blood pressure — 2 to 3 mmHg — could result in a 25 percent to 50 percent decrease in the incidence of high blood pressure, also known as hypertension, Halm said. “That would result in an annual reduction of stroke, coronary heart disease and all-cause mortality by 6 percent, 4 percent and 3 percent, respectively,” he said.

Exercise — as part of a comprehensive lifestyle-modification program including weight loss, low-salt diet, diets rich in fruits and vegetables and low in saturated fats — has beneficial effects on blood pressure, Halm said.

“It is thus appropriate to recommend exercise as most patients will follow their physician recommendations and this is associated with improved blood pressure control and likely a reduction in the morbidity and mortality associated with uncontrolled blood pressure,” he said.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, thinks more needs to be done to get patients to make lifestyle changes that will reduce their blood pressure.

“Despite clinical trial evidence and national guideline recommendations for exercise counseling to be provided for patients with high blood pressure, this study demonstrates that only one-third of these eligible patients received exercise counseling,” he said.

“Much more needs to be done to ensure that patients with high blood pressure receive appropriate counseling on lifestyle change — including counseling on the importance of regular aerobic exercise — from their physicians,” Fonarow said.

(Source: Josiah Halm, M.D., clinical assistant professor, medicine, and hypertension specialist, University of Wisconsin School of Medicine and Public Health, Milwaukee; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Summer 2008 Ethnicity & Disease )