How to Prevent, Treat High Blood Pressure With Exercise

Individualized recommendations for the best exercise to lower blood pressure were recently published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC). According to the ESC, there are specific exercises a person can engage in based on their current blood pressure level.

In the article, the ESC highlighted the importance of the adoption of these recommendations, because 1 in 4 heart attacks are currently caused by high blood pressure, with estimates predicting that approximately 60% of the global population will have hypertension by 2025.

Although it is widely known that exercise can lower blood pressure, previous recommendations focused on the amount of exercise per week that should be achieved, regardless of an individual's starting blood pressure level.

The ESC based their recommendations on the consensus of experts in the field and on the thorough analysis of available data on the subject.

Based on the data, the paper describes how to best lower blood pressure in people with hypertension, high-normal blood pressure, and normal blood pressure. For each group, the guidance outlines the first exercise priority to focus on, followed by alternatives that accomplish a similar but slightly lower level of blood pressure reduction.

"The goal of the recommendations for all three groups is primarily to lower blood pressure," said first author Henner Hanssen, MD, professor at the University of Basel, Switzerland, in a press release. "Ultimately, through blood pressure reduction, we can reduce the risk of heart attack, stroke, and death from cardiovascular disease—thereby spending more years of life in good health."

The guidance notes that for people who already have hypertension, which is blood pressure of at least 140/90 mmHg, aerobic exercise has the greatest efficacy in blood pressure reduction. Such exercise can include walking, running, cycling, or swimming.

"In people with hypertension, the blood pressure reduction that can be achieved with aerobic exercise is the same, or even slightly more, than taking a single antihypertensive medication," said Hanssen in the press release.

For individuals with high-normal blood pressure, which is defined as 130-139/85-89 mmHg, the inclusion of resistance training during exercise is the first priority. This kind of training typically involves at least 6 large muscle groups through which muscle contraction results in movement, such as lifting weights, squats, and push-ups.

Individuals with normal blood pressure, which is defined as less than 130/84 mmHg, should prioritize isometric resistance training. This type of training involves the static contraction of muscles, such as with the handgrip exercise.

"People with normal blood pressure, but who are at raised risk of developing hypertension, may be particularly motivated to keep their levels down," Hanssen said in the press release. "Obese individuals are very likely to develop high blood pressure if obesity persists over the years. Healthy individuals with a hypertensive parent are also at risk of developing high blood pressure, as are women who had high blood pressure during pregnancy (gestational hypertension). People in these groups can postpone or even prevent hypertension by exercising."

Hanssen additionally explained that the benefits of these exercises specifically come from consistency in order to maintain the health results for each group.

"For most exercises, the blood pressure lowering effect lasts for about 24 hours, similar to medication, so it's best to be active every day if possible," Hanssen said in the press release.

REFERENCE

How to prevent and treat high blood pressure with exercise. European Society of Cardiology; March 23, 2021. https://www.eurekalert.org/pub_releases/2021-03/esoc-htp032221.php. Accessed March 26, 2021.