According to the World Health Organisation, one in four men and one in five women suffer from high blood pressure. But most people with hypertension are not even aware of their blood pressure, which is why it is often referred to as the 'silent killer'.
About a quarter of all heart attacks are caused by high blood pressure. And by 2025, about 60% of the world's population is expected to have high blood pressure. It is widely accepted that exercise can lower blood pressure. Recommendations for exercise have mainly focused on the amount of exercise per week, without considering targeted exercise recommendations for each person's starting blood pressure level.
Can exercise help blood pressure?
One study showed that those who were most physically active had a 19% lower risk of developing hypertension in the future compared to those who were least physically active for people with normal blood pressure. (1)
If hypertension was present, those who were most physically active had a 13% reduced risk of progression of hypertension and a 17% increased likelihood of remission of hypertension.
In addition, sedentary people who started exercising reduced their risk of hypertension by 25%, while formerly active people who became inactive had no protective effect from their previous exercise.
Another research suggests that if we want to protect ourselves from high blood pressure in old age, we need to start exercising from a young age and maintain our exercise levels well into middle age. (2)
Kirsten Bibbins-Domingo, an epidemiologist at the University of California San Francisco Parnassus Campus (UCSF) and author of the study, said, "Teenagers and early 20s are fit, but health changes with age.
"Many studies have shown that exercise can lower blood pressure, but new research suggests that exercising at a younger age - at higher levels than previously recommended - may be particularly important in preventing high blood pressure."
Hypertension is a severe condition that affects billions of people worldwide. It can cause heart attacks and strokes; it is also a risk factor for developing dementia in later life.
The study recruited more than 5,100 adults; their physical fitness, exercise habits, smoking status and alcohol intake (via questionnaires) were assessed to track their health over three decades.
During each clinical assessment, blood pressure was measured three times, one minute apart. For data analysis, participants were divided into four categories by ethnicity and gender.
Overall, physical activity levels got lower and lower from the age of 18 to 40, with rates of hypertension rising and physical activity falling in the following decades.
According to the researchers, this suggests that youth is a critical window.
When the researchers looked at people who did five hours of moderate exercise per week in their early years - twice the minimum amount of exercise currently recommended for adults - they found that this level of activity significantly reduced the risk of hypertension, especially if people kept their exercise habits maintained until age 60.
For the prevention of hypertension, achieving twice the minimum amount of exercise in the current guidelines may be more beneficial," the researchers wrote in their paper.
However, increasing the number of hours of exercise per week is not easy.
Especially after high school, as young people transition to college, work and parenthood, there are fewer opportunities to engage in physical activity and not enough leisure time.
What exercises are recommended for different blood pressure levels?
Researchers from the University of Oxford and the University of Connecticut have suggested, based on the latest evidence on heart health and exercise, that exercise may work better than drugs to lower high blood pressure, especially if people choose the right type of exercise for them. According to a recent recommendation in the European Journal of Preventive Cardiology, Different exercises should be recommended depending on blood pressure levels.(3)
People with high blood pressure
Aerobic exercise is the most effective method, including walking, running, cycling or swimming. In people with hypertension, aerobic exercise can be used to achieve a reduction in blood pressure.
Pre-hypertension (systolic blood pressure 120-139 mmHg, diastolic blood pressure 80-89 mmHg)
Plyometric training is the priority and usually involves at least six large muscle groups, such as weights, squats and push-ups. Weight training does not cause a change in blood pressure during exercise but rather lowers it; although weight training causes an immediate increase in blood pressure, it decreases significantly as the heart adjusts.
People with normal blood pressure
Resistance exercises are the most beneficial, physical activities that allow the muscles to feel the resistance through muscles against external resistance, using dumbbells, barbells and elastic bands.
Exercise regularly to maintain the benefits. For most of the exercises, the effect lasts for about 24 hours and is similar to medication, so it is best to keep doing these activities every day if you can.
1. Cai C, Liu FC, Li JX,et al. Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension. J Geriatr Cardiol. 2021 Mar 28;18(3):175-184.
2. Jason M. Nagata, Eric Vittinghoff, Kelley Pettee Gabriel, Andrea K. Garber, Andrew E. Moran, Stephen Sidney, Jamal S. Rana, Jared P. Reis, Kirsten Bibbins-Domingo,Physical Activity and Hypertension From Young Adulthood to Middle Age, American Journal of Preventive Medicine,
2021,ISSN 0749-3797,https://doi.org/10.1016/j.amepre.2020.12.018.
3. Henner Hanssen, Henry Boardman, Arne Deiseroth, Trine Moholdt, Maria Simonenko, Nicolle Kränkel, Josef Niebauer, Monica Tiberi, Ana Abreu, Erik Ekker Solberg, Linda Pescatello, Jana Brguljan, Antonio Coca, Paul Leeson, Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension, European Journal of Preventive Cardiology, 2021;, zwaa141, https://doi.org/10.1093/eurjpc/zwaa141
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