Regular exercise may not help patients with severe high blood pressure as much as it does those with moderate hypertension. Yvonne Plantinga and her colleagues at the University of Pisa in Italy examined artery elasticity in 400 middle-aged volunteers. Stiffer arteries increase pressure on the heart. Regular exercise reduced stiffness in patients with normal or mildly high blood pressure but not in those with untreated, more severe conditions. “Medication and exercise would do better than just medication for those patients,” Plantinga suggested at the American Society of Hypertension conference in May.

At the meeting, experts also moved to extend the definition of hypertension, suggesting it is a syndrome whose early stages can include normal blood pressure (a reading below 120/80). Exaggerated blood pressure response to exercise or mental stress, small amounts of protein in the urine, and an impaired ability to process blood sugar are among several symptoms that can be signs. Redefining hypertension may help physicians identify the disease earlier.