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