DOCTOR'S VIEW ARCHIVE

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.

The ways (mechanisms) by which exercise can cause a reduction in blood pressure are unclear. Nevertheless, studies have shown that insulin resistance and high blood insulin levels may contribute to hypertension. (In insulin resistance, the body develops an immune or antibody response to its own insulin that impairs the effectiveness of the insulin. Insulin is a hormone that regulates the blood sugar.) Moreover, other studies have demonstrated that aerobic exercise reduces insulin resistance and insulin levels in hypertensive patients. This effect of exercise on insulin, therefore, might be one possible explanation for the beneficial effects of regular exercise on blood pressure.

In conclusion, lifestyle modifications can have an important role in the treatment and prevention of hypertension. Now, we can add regular exercise to the list of lifestyle modifications that includes dietary changes, reduction in salt intake in certain individuals, smoking cessation, limited alcohol intake, weight control, moderation of caffeine intake, control of blood fats (lipids), and compliance with prescribed medications when they are needed.


Last Editorial Review: 5/6/2008