With growing concerns about the cost, effectiveness, and potential side effects of blood pressure medications, a group of researchers looked closer at how exercise compares to medications for treatment of hypertension. Their conclusion was good news for those of us who like to stay fit. Get-Fit Guy explains.
In late 2017, around 30 million Americans suddenly failed their blood pressure test. This was partly due to the season finale of Game of Thrones but mostly due to the American Heart Association lowering the measuring stick on what they consider to be healthy blood pressure. Since then, high blood pressure has been defined as 130/80 millimetres of mercury or greater (tightened from the previous 140/90). You can read more about that in my article Can Exercise Lower Your Blood Pressure?
If you need a reminder of how your BP works, your total blood pressure is determined by measuring your systolic and diastolic blood pressures.
- Systolic blood pressure (the top number) measures the force your heart exerts on the walls of your arteries each time it beats.
- Diastolic blood pressure (the bottom number) measures the force your heart exerts on the walls of your arteries in between beats.
If you have failed your blood pressure test more than once, it is likely that your doctor has advised you to take a medication to control it. They may also have suggested that you do things like reducing your salt intake and try meditation or other de-stressing practices. Well based on new research soon folks with high blood pressure may get sent to see a coach like me instead of to the pharmacy.
Dr. Huseyin Naci Ph.D. recently published a meta-analysis in the British Journal of Sports Medicine that compares the effectiveness of exercise and antihypertensive medications on lowering blood pressure. The objective was to compare the effect of exercise regimens and medications on systolic blood pressure.
To do this, the researchers looked at randomized controlled trials of some of the most commonly prescribed blood pressure medications (angiotensin-converting enzyme inhibitors, angiotensin-2 receptor blockers, β-blockers, calcium channel blockers, and good old diuretics) from existing Cochrane reviews. Then they compared those results to the previously published meta-analysis of exercise interventions that tested the blood pressure lowering effects of endurance, dynamic resistance, isometric resistance, and combined endurance and resistance exercise interventions.
The researchers noticed that a portion of the studies done on how effective exercise is on lower blood pressure was actually done on individuals who did not have what would clinically be categorized as "high blood pressure" but the studies done on the effectiveness of medication were. This gave an inaccurate comparison. But once the analysis was adjusted to only include studies done on individuals with a systolic blood pressure of 140 or higher, the results were tallied.
Although the effect of exercise interventions on blood pressure remains under-studied (especially among populations who are living with high blood pressure) their findings confirm that the blood pressure lowering effect of exercise appears similar to that of the commonly used medications. That's right—a similar drop in systolic blood pressure was seen when patients went for a walk as it did when they popped the pill.
To achieve the blood pressure lowering effects, the researchers recommend adults with hypertension participate in 30 to 60 minutes per day of moderate to vigorous intensity aerobic exercise (such as walking or jogging) most days of the week in combination with resistance training a couple days per week. Simple, right? Especially if you are already living an active lifestyle that incorporates moving as much as possible throughout the day.
Keep in mind that just like taking the meds every day, you do need to continue exercising to continue to see the pressure lowering benefits. Which I take as just another excuse to renew my gym membership, keep my bike in good working order, always have a pair of runners near the door, and a full charge on my MP3 player.