Exercise Testing in Hypertensive Patients

To the Editor.— We refer to the recent article entitled "Treadmill Exercise Testing in Hypertensive Patients Treated with Hydrochlorothiazide and β-Blocking Drugs" by Miller et al. 1 We note that the authors develop an argument for using exercise to assess the efficacy of hypertensive treatment and hope to devise a simple test using a treadmill. It might be regarded as rather cumbersome for hypertensive patients to exercise routinely with the treadmill because of the large numbers involved, and we would like to describe our practice, which we believe is a valid and a reasonable alternative and which is applied to all our hypertensive patients routinely 2 in the hypertension clinic. Patients are asked to step up onto and down from a 9-in step 24 times in one minute. This involves 48 movements of each foot and is performed in time with a metronome beating at 96 times per minute. The