Aerobic Exercise
Author: Richard Weil, MEd, CDE
Medical Editor: Melissa Conrad Stöppler, MD
High Blood Pressure and Exercise
Medical Author: Dwight
Makoff, MD and Melissa Conrad Stöppler, MD
Medical Editor: Leslie
J. Schoenfield, MD, PhD
A sedentary lifestyle is a major risk factor for heart and blood
vessel (cardiovascular) disease. For example, people who are less active and
less physically fit have a 30%-50% greater frequency (incidence) of
hypertension (high blood pressure) than their more active peers. Furthermore, clinical trials have shown that
physical activity may reduce blood pressure in hypertensive and normotensive
(having normal blood pressure) individuals, independent of changes in weight.
Medications have proven to be effective in lowering blood pressure and
protecting against the risk of cardiovascular and kidney (renal) diseases.
However, because of the side effects and cost of medications, many individuals would prefer to undertake lifestyle modifications to help improve blood pressure as a first-line treatment. In numerous clinical studies, it has been well documented that aerobic exercise is a suitable
treatment and can even play a roll in the prevention of hypertension. (Aerobic
exercise is vigorous and sustained exercise, such as jogging, swimming,
and cycling.)
Even without changes in body weight, those individuals who participate in aerobic exercise regularly tend to have reductions in resting blood pressure. The blood-pressure reduction does not seem to depend on the frequency or intensity of aerobic exercise or on the type of exercise. That is, the studies have indicated that all forms of exercise seem to be effective in reducing blood pressure. Aerobic exercise appears to have a slightly greater effect on blood pressure in hypertensive individuals than in individuals without hypertension.
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What is aerobic exercise?
Imagine that you're exercising. You're working up a sweat, you're breathing
hard, your heart is thumping, blood is coursing through your vessels to deliver
oxygen to the muscles to keep you moving, and you sustain the activity for more
than just a few minutes. That's aerobic exercise; any activity that you can
sustain for more than just a few minutes while your heart, lungs, and muscles
work overtime. In this article, I'll discuss the mechanisms of aerobic exercise;
oxygen transport and consumption, the role of the heart and the muscles, the
proven benefits of aerobic exercise, how much you need to do to reap the
benefits, and more.
The beginning
It all starts with breathing. The average healthy adult inhales
and exhales about 7 to 8 liters of air per minute. Once you fill your lungs, the
oxygen in the air (air contains approximately 20% oxygen) is filtered through
small branches of tubes (called bronchioles) until it reaches the alveoli. The
alveoli are tiny sacs (they kind of look like bunches of grapes, and you have
about 300,000,000 in each lung!) where oxygen diffuses (enters) into the blood.
From there, it's a beeline direct to the heart.
Getting to the heart of it
The heart has four chambers that fill with blood
and pump blood (two atria and two ventricles) and some very large and active
coronary arteries. Because of all this action, the heart needs a fresh supply of
oxygen, and as you just learned, the lungs provide it. Once the heart uses what
it needs, it pumps the blood, the oxygen, and other nutrients out through the
large left ventricle and through the circulatory system to all the organs,
muscles, and tissue that need it.
A whole lot of pumping going on
Your heart beats approximately 60-80 times
per minute at rest, 100,000 times a day, more than 30 million times per year,
and about 2.5 billion times in a 70-year lifetime! Every beat of your heart
sends a volume of blood (called stroke volume—more about that later), along
with oxygen and many other life-sustaining nutrients, circulating through your
body. The average healthy adult heart pumps about 5 liters of blood per minute.
Oxygen consumption and muscles
All that oxygen being pumped by the blood is
important. You may be familiar with the term "oxygen consumption." In science,
it's labeled VO2, or volume of oxygen consumed. It's the amount of oxygen the
muscles extract, or consume from the blood, and it's expressed as ml/kg/minute
(milliliters per kilogram of body weight). Muscles are like engines that run on
fuel (just like an automobile that runs on fuel); only our muscles use fat and
carbohydrates instead of gasoline. Oxygen is a key player because, once inside the
muscle, it's used to burn fat and carbohydrate for fuel to keep our engines
running. The more efficient our muscles are at consuming oxygen, the more fuel
we can burn, the more fit we are, and the longer we can exercise.
Next: How aerobically fit can we be? »
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