Improving cardiovascular autonomic function in postmenopausal women with hypertension: a pilot study of supervised versus home-based aerobic exercise

Objective – Arterial hypertension is a major global cause of cardiovascular disease, a risk heightened by postmenopausal physiological changes. Although aerobic exercise is protective, its optimal intensity, duration, and supervision for hypertensive postmenopausal women remain unclear. This study, therefore, compares a supervised intensive aerobic program with a home-based regimen, assessing their effects on key cardiac health indicators in this population. Methods – In this single-center pilot randomized controlled trial, we enrolled 31 postmenopausal women. Participants were divided into two groups: one underwent a 6-week supervised intensive aerobic exercise program, and the other followed a home-based exercise regimen. Key outcome measures included cardiorespiratory endurance, heart rate variability, and blood pressure variability. Outcome measures were evaluated at weeks 6 and 12. Intra-group and inter-group comparisons were evaluated using appropriate statistical methods. Results – After 12 weeks, the supervised exercise group showed significant improvements in VO2max (P = 0.003), metabolic equivalents (METs) (P = 0.002), and standard deviation of normal-to-normal intervals (SDNN) values (P = 0.034) at both the 6th and 12th weeks. However, the sole significant inter-group difference was a greater reduction in 24-hour SBP variability (SBP-SD) in the supervised arm (Δ –0.95 ± 1.15 vs. + 1.54 ± 0.94 mmHg; P = 0.041), driven mainly by the week 6–12 interval (P = 0.004). Conclusion – Supervised intensive aerobic exercise produced clear within-group gains in VO₂ max, METs, and SDNN, and it reduced 24-hour SBP variability relative to home-based walking. Although between-group differences for the primary fitness and autonomic outcomes were not statistically significant in this pilot, the pattern suggests that a supervised, tailored program may confer additional clinical benefit and merits evaluation in a larger trial.