***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Regular physical exercise is broadly recommended by current European and American hypertension guidelines . It remains elusive , however , whether exercise leads to a reduction of blood pressure in resistant hypertension as well . The present r and omized controlled trial examines the cardiovascular effects of aerobic exercise on resistant hypertension . Resistant hypertension was defined as a blood pressure ≥140/90 mm Hg in spite of 3 antihypertensive agents or a blood pressure controlled by ≥4 antihypertensive agents . Fifty subjects with resistant hypertension were r and omly assigned to participate or not to participate in an 8- to 12-week treadmill exercise program ( target lactate , 2.0±0.5 mmol/L ) . Blood pressure was assessed by 24-hour monitoring . Arterial compliance and cardiac index were measured by pulse wave analysis . The training program was well tolerated by all of the patients . Exercise  significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg , respectively ( P=0.03 each ) . Regular exercise  reduced blood pressure on exertion and increased physical performance as assessed by maximal oxygen uptake and lactate curves . Arterial compliance and cardiac index remained unchanged . Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment . It should be included in the therapeutic approach to resistant hypertension To verify whether there are relationships between vascular and hormonal responses to aerobic training in hypertensive persons , sedentary hypertensive patients were r and omized to an aerobic training or a callisthenic exercise group . The patients ' 24-hour blood pressure , arterial compliance , forearm blood flow , and hormonal profile were evaluated at baseline and after 3-month training protocol s. Mean maximal oxygen consumption ( VO(2 ) max ) increased by 8 % in the aerobic group ( P<.001 ) , while no change was observed in the control group . There was a decrease in insulin resistance ( homeostatic model assessment of insulin resistance , P=.039 ) and plasma cortisol ( P=.006 ) in the aerobic group only , that also demonstrated an increase in forearm blood flow ( P<.001 ) after training . No relationship was observed between change in blood pressure or change in body mass and other parameters . Aerobic training can promote a decrease in cardiovascular risk in hypertensive adults by improving vascular function and insulin resistance , despite no changes in ambulatory blood pressure after a 3-month intervention Background Hypertension ( HTN ) exhibits sexual dimorphism ; the incidence for women surpasses men during the sixth decade of life , while the pharmacological treatments are less effective and produce more side-effects in women than in men . Aerobic exercise ( AE ) has been shown to prevent and treat HTN ; however , resistance exercise ( RE ) is not recommended as a strategy to treat HTN . In this study , we investigated the potential sex differences of AE versus RE in a cohort of unmedicated patients with hypertension . Methods In total , 40 moderately active , pre-hypertensive or stage 1 essential hypertensive male ( M ) and female ( F ) participants aged 40 to 60 years were r and omly divided into four groups : M AE , M RE , F AE , and F. Each group exercised at moderate intensity , 3 days/week for 4 weeks . Hemodynamic , vascular and blood-flow data were collected before and after exercise training . Results Men showed a significant increase in central pulse wave velocity following RE while females showed no significant changes ( 12 ± to 13.9 ± vs. 9.2 ± to 9.6 ± m/s , respectively ) . RE showed significantly greater increases in peak blood flow when compared to AE ( F RE 15 ± to 20 ± vs. F AE 17.5 ± to19.5 ± , M RE 19 ± to 24 ± vs M AE 21 ± to 25 ± ml * 100 ml*min , respectively ) . In addition , systolic and diastolic BP decreased greater for women following RE when compared to AE whereas men showed comparable decreases in BP following either exercise mode . Conclusion Moderate-intensity RE training may be a more favorable for women as a treatment option for hypertension because of greater decreases in diastolic BP and significant increases in flow-mediated dilation without concomitant increases in arterial stiffness , compared with their male counterparts OBJECTIVES This study determined the relative efficacy of aerobic exercise ( daily walking ) and moderate dietary sodium restriction ( sodium intake < 100 mmol/day ) for reducing systolic blood pressure ( SBP ) and pulse pressure ( PP ) in postmenopausal women with elevated initial levels , and the potential role of reductions in large artery stiffness in these changes . BACKGROUND Lifestyle behaviors are recommended for lowering blood pressure ( BP ) in adults with elevated baseline levels , but there is little information as to the relative efficacy of different interventions or the mechanisms underlying their potential beneficial effects . METHODS After baseline measurements and r and om assignment , 35 nonmedicated healthy postmenopausal women with SBP between 130 and 159 mm Hg completed three months of either  aerobic ( walking ) exercise ( n = 18 ; 62 + /- 9 years , mean + /- SD ) or moderate dietary sodium restriction ( SR ) ( n = 17 ; 65 + /- 10 years , mean + /- SD ) . RESULTS Body mass and composition , plasma volume , and fasting concentrations of metabolic coronary risk factors did not differ between the groups at baseline or change with intervention . Systolic BP and PP at rest decreased with both exercise and SR ( p < 0.05 ) ; however , the reductions were three- to fourfold greater with SR ( p < 0.05 ) . Sodium restriction , but not exercise , also reduced 24-h SBP and PP ( p < 0.05 ) . Aortic pulse wave velocity ( PWV ) and carotid augmentation index were reduced only with SR ( p < 0.05 ) . Changes in SBP and PP at rest and over 24 h correlated with the corresponding changes in aortic PWV ( r = 0.53 to 0.61 , p < 0.01 ) . CONCLUSIONS Moderate SR lowers SBP and PP in postmenopausal women with elevated baseline levels more than does daily walking . The greater blood pressure reductions with SR may be mediated in part by a decrease in the stiffness of the large elastic arteries Physical training is associated with an increase in arterial distensibility . Whether the effect of training on this variable is evident also for ordinary levels of exercise or no exercise is unknown , however . We have addressed this issue by investigating the effect on radial artery distensibility of prolonged monolateral immobilization of the ipsilateral limb versus the following resumption of normal mobility . We studied 7 normotensive subjects ( age , 25.4+/-3.0 years ; systolic/diastolic blood pressure , 119+/-9/68+/-6 mm Hg , mean+/-SE ) in whom 1 limb had been immobilized for 30 days in plaster because of a fracture of the elbow . At both the day after plaster removal and after 45 days of rehabilitation , radial artery distensibility was evaluated by an  echo-tracking device ( NIUS-02 ) , which allows arterial diameter to be measured noninvasively and continuously over all pressures from diastole to systole ( finger monitoring ) , with the distensibility values being continuously derived from the Langewouters formula . In both instances , the contralateral arm was used as control . Immediately after removal of the plaster , radial artery distensibility was markedly less in the previously immobilized and fractured limb compared with the contralateral limb ( 0.4+/-0.1 versus 0.8+/-0.1 , 1/mm Hg 10(-3 ) , P<0.05 ) . After rehabilitation , the distensibility of the radial artery was markedly increased in the previously fractured limb ( 0.65+/-0.1 1/mm Hg 10(-3 ) , P<0.05 ) , whereas no change was seen in the contralateral limb . Thus , complete interruption of physical activity is associated with a marked reduction of arterial distensibility , indicating that even an ordinary level of activity plays a major role in modulation of arterial mechanical properties Background Aerobic exercise is broadly recommended as a helpful adjunct to obtain blood pressure control in hypertension . Several hypertensive patients , however , are limited by musculoskeletal complaints or vascular occlusive disease from lower-limb exercise such as jogging or cycling . In the present r and omized-controlled study , we evaluate whether an aerobic arm-cycling program provides a measurable cardiovascular benefit . Methods Twenty-four prob and s were r and omly assigned to sedentary activity or a heart rate controlled 12 week exercise program , consisting of arm-cycling at target lactate concentrations of 2.0 ± 0.5 mmol/l . Endothelial function was assessed by flow-mediated dilation of the brachial artery . Augmentation index and large/small artery compliance ( C1 and C2 ) were measured by computerized pulse-wave analysis of the radial artery . Results The exercise program led to a significant reduction in systolic ( 134.0 ± 20.0 to 127.0 ± 16.4 mmHg ; P = 0.03 ) and diastolic blood pressure ( 73.0 ± 21.6 to 67.1 ± 8.2 mmHg ; P = 0.02 ) accompanied by a significant improvement in C2 ( 3.5 ± 1.6 to 4.8 ± 2.0 ml/mmHg × 100 ; P = 0.004 ) . Flow-mediated dilation , augmentation index , and C2 were not significantly affected ( P > 0.05 ) . Physical performance as derived from lactate and heart rate curves of lower-limb stress tests was unchanged , whereas maximal workload in an upper-limb ergometry significantly increased ( P = 0.005 ) . Blood pressure and vascular parameters remained unchanged in the control group . Conclusion Regular arm aerobic exercise leads to a marked reduction in systolic and diastolic blood pressures and an improvement in small artery compliance . Arm-cycling is a reasonable option for hypertensive patients who want to support blood pressure control by sports despite having coxarthrosis , gonarthrosis , or intermittent claudication The benefits of aerobic exercise ( AE ) training on  blood pressure ( BP ) and arterial stiffness are well established , but the effects of resistance training are less well delineated . The purpose of this study was to determine the impact of resistance vs aerobic training on haemodynamics and arterial stiffness . Thirty pre- or stage-1 essential hypertensives ( 20 men and 10 women ) , not on any medications , were recruited ( age : 48.2±1.3 years ) and r and omly assigned to 4 weeks of either resistance ( RE ) or AE training . Before and after training , BP , arterial stiffness ( pulse wave velocity ( PWV ) ) and vasodilatory capacity ( VC ) were measured . Resting systolic BP ( SBP ) decreased following both training modes ( SBP : RE , pre 136±2.9 vs post 132±3.4 ; AE , pre 141±3.8 vs post 136±3.4 mm Hg , P=0.005 ; diastolic BP : RE , pre 78±1.3 vs post 74±1.6 ; AE , pre 80±1.6 vs post 77±1.7 mm Hg , P=0.001 ) . Central PWV increased ( P=0.0001 ) following RE ( 11±0.9–12.7±0.9 m s−1 ) but decreased after AE ( 12.1±0.8–11.1±0.8 m s−1 ) . Peripheral PWV also increased ( P=0.013 ) following RE ( RE , pre 11.5±0.8 vs post 12.5±0.7 m s−1 ) and decreased after AE ( AE , pre 12.6±0.8 vs post 11.6±0.7 m s−1 ) . The VC area under the curve ( VCAUC ) increased more with RE than that with AE ( RE , pre 76±8.0 vs post 131.1±11.6 ; AE , pre 82.7±8.0 vs post 110.1±11.6 ml per min per s per 100 ml , P=0.001 ) . Further , peak VC ( VCpeak ) increased more following resistance training compared to aerobic training ( RE , pre 17±1.9 vs post 25.8±2.1 ; AE , pre 19.2±8.4 vs post 22.9±8.4 ml per min per s per 100 ml , P=0.005 ) . Although both RE and AE  training decreased BP , the change in pressure may be due to different mechanisms The present study characterized large-artery properties in patients with isolated systolic hypertension ( ISH ) and determined the efficacy of exercise training in modifying these properties . Twenty patients ( 10 male and 10 female ) with stage I ISH and 20 age- and gender-matched control subjects were recruited , and large-artery properties were assessed noninvasively . Ten ISH patients ( 5 male and 5 female ) were enrolled in a r and omized crossover study comparing 8 weeks of 
    Output:
    
Arterial stiffness is not reduced in (pre)hypertensive subjects in response to aerobic training unless associated with a substantial reduction in SBP and /or prolonged duration