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August 20, 2003

Effects of Exercise and Weight Loss on Hypertension—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(7):885. doi:10.1001/jama.290.7.885-a

To the Editor: The authors of the PREMIER trial1 found that a comprehensive lifestyle approach, either with or without the addition of dietary counseling, resulted in significant decreases in blood pressure (BP) and excess body weight among adults with above-optimal BP.

There are 2 ways that the authors' interventions could have been more optimally designed. First, they limited the exercise recommendation to a minimum of 30 min/d. Several studies24 have suggested that 30 minutes of moderate physical activity daily is not enough to achieve optimal weight control. Thus, the World Health Organization recently recommended a minimum of 1 hour of moderate physical activity nearly every day for everyone, whether the activity is recreational or occupational.5 Second, the relatively short (6-month) intervention and follow-up periods may have been too brief to reach the desired levels of fruit and vegetable intake. This is more likely to be achieved by several years of persistent encouragement.6

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