News from the AMA:
Exercise Training Improves Cardiovascular Consequences of Type 2 Diabetes and Hypertension

October 2, 2002 The beneficial effects of exercising on the cardiovascular system may help improve the condition of people with type 2 diabetes and hypertension, according to a review article in the October 2 issue of The Journal of the American Medical Association.

According to background information in the article, exercise provides multiple benefits, including improved cardiovascular functioning, reduction in body fat and an increase in muscle mass changes that also may improve sensitivity to insulin (which people with type 2 diabetes have difficulty with) and blood pressure. Because of these health improvements, researchers have suggested that exercise might have positive effects on patients with type 2 diabetes and hypertension.

Kerry J. Stewart, Ed.D., of Johns Hopkins School of Medicine in Baltimore, Md., performed a search of the medical literature from January 1985 to June 2002 to gather information on exercise, type 2 diabetes and hypertension, and provided exercise guidelines for patients with type 2 diabetes and hypertension based on the articles found.

The analysis evaluated 235 citations from peer-reviewed journals, professional society guidelines and books.

The exercise recommendations for patients with type 2 diabetes and hypertension include:

  • Warm-up and cool-down period of five to 10 minutes each including stretching


  • Aerobic exercise including walking, cycling and swimming at 55 percent to 79 percent of maximum heart rate (or 50 percent to 60 percent of maximum heart rate for patients with low initial fitness levels) for 30 to 45 minutes.


  • Resistance training, including weight lifting for 20 minutes for one set each for 8 to 10 exercises.


  • Aerobic exercise should be done three to four times a week and more frequently if weight reduction is the goal.


  • Resistance exercise should be done twice a week.

"This review of the available data suggests plausible mechanisms by which exercise training improves the cardiovascular consequences of type 2 diabetes and hypertension, mechanisms that go beyond the established benefits of exercise on glycemic control and blood pressure reduction," concludes Dr. Stewart.