The Contribution of Exercise in Telemedicine Monitoring in Reducing the Modifiable Factors of Hypertension—A Multidisciplinary Approach

Abstract

The aim of this review was to explore the contribution of physical activity and exercise in the control and reduction of modifiable factors of arterial hypertension in telemedicine programs, assuming a multidisciplinary perspective. Searches were carried out following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and the research question defined using the PICOS approach (Population, Intervention, Comparator, Outcomes, Study design). The search strategy applied the following terms: blood pressure OR hypertension AND exercise OR physical activity AND telemedicine. The initial search identified 2190 records, but only 19 studies were considered eligible after checking for the inclusion and exclusion criteria. The following training variables were generally included: heart rate and heart rate reserve, respiratory rate, rate of perceived exertion and oxygen consumption, but no resistance training variables were found. The significant improvements on blood pressure parameters of participants diagnosed with hypertension tended to be transient. The exercise prescription was commonly based on general instructions and recommendations for exercise and hypertension. On the other hand, most of the studies including patients in cardiac rehabilitation programs used a personalized training program based on a baseline assessment, particularly following a cardiopulmonary exercise test. The inclusion of exercise professionals in multidisciplinary teams could provide a more person-oriented approach and the long-term maintenance of a healthy lifestyle.

A Need for Improvement in the Definition of Resistant Arterial Hypertension

“…How many patients succeed in complete healthy lifestyle adoption? Numbers are low [41][42][43][44][45], and the question remains-for how long does a healthy lifestyle need to be maintained [42,[46][47][48]? We are aware that drug adherence is disappointingly low (e.g., 20-50%) [49][50][51], and that adopting a healthy lifestyle needs much more effort and time [52].…”