Home-based aerobic exercise in postmenopausal women with hypertension results in no significant improvement in maximal oxygen uptake (VO₂ max) or heart rate variability (SDNN) compared to supervised exercise, but is associated with increased 24-hour systolic blood pressure variability.

When people exercise with supervision, their heart and blood vessels respond by releasing a chemical that relaxes blood vessels, which improves the body's ability to detect and correct blood pressure changes. This leads to slower, steadier heartbeats and less fluctuation in blood pressure over the day. Without supervision, this process does not activate fully, so blood pressure continues to swing widely even if the person exercises.