Comparative Analysis of cardiac rehabilitation programs versus Standard Care in resistant hypertension

Ryo Kobayashi; H. Ito; E. Ito

doi:10.5281/zenodo.22814628

Authors

Ryo Kobayashi Department of Cardiology, Don Center for Cardiology Author https://orcid.org/2429-6322-2701-1663
H. Ito Division of Cardiovascular Medicine, Mekong Center for Cardiovascular Medicine Author https://orcid.org/5446-4940-7556-2437
E. Ito Division of Cardiovascular Medicine, Congo Research Center for Cardiology Author https://orcid.org/9861-2533-9399-7155

DOI:

https://doi.org/10.5281/zenodo.22814628

Keywords:

resistant hypertension, cardiac rehabilitation, exercise training, blood pressure control, standard care

Abstract

Graphical abstract

Background: Resistant hypertension, blood pressure above goal despite three or more optimally dosed antihypertensive agents, affects a substantial minority of treated hypertensive adults and carries elevated cardiovascular risk.

Objective: This review compares structured cardiac rehabilitation programs against standard pharmacological care alone for blood pressure reduction and risk-factor control in resistant hypertension.

Methods: We synthesized randomized trials, systematic reviews, and major scientific statements on exercise-based rehabilitation, lifestyle intervention, pharmacological escalation, and device-based therapy in hypertensive and resistant hypertensive populations.

Findings: Structured exercise training within a rehabilitation framework, alongside dietary counseling and risk-factor management, produced significantly greater ambulatory and office blood pressure reductions than standard care alone, with effects additive to pharmacological escalation and device-based approaches via improved baroreflex sensitivity and reduced sympathetic activation.

Conclusions: Cardiac rehabilitation is a practical, evidence-supported adjunct to standard care in resistant hypertension, and expanding referral criteria and home-based delivery could improve access for this high-risk population.

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