Blood Pressure and Exercise

Jarrod Wilson (Exercise Physiologist – Burnie)

Did you know that hypertension (high blood pressure) is the most common condition that affects the circulatory system; the heart and blood vessels?

Blood pressure remains a vital health measurement and is a key indicator in determining the risk of potentially serious health events (e.g. stroke, heart attack, etc.). It is simply a measurement that every person should strive to achieve optimal control with.

That being said it may be enough to shock you that 1 in 3 Australians over 18 years of age have hypertension and in 68% of these cases blood pressure is ‘uncontrolled’.

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Exercise and Sports Science Australia has recently released an updated position statement on ‘Exercise and Hypertension’. Here is what we know about the benefits of exercise on controlling blood pressure and what considerations you may need to take when performing any form of physical activity.

Generally speaking hypertension is more likely to develop in people who do not meet the requirements with physical activity, those who are overweight (BMI of over 30kg/m), have a high waist circumference (over 102cm in men and over 88cm in women) and in people who consume excess dietary sodium or alcoholic drinks. There is also a strong link with a family history of hypertension. Of these risk factors for developing hypertension, most are within individual control; that is with the right strategies most people can reduce their blood pressure and stabilise it within the ‘normal’ range. Below is a table of what is classified as ‘normal’.

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Exercise

There has been a wealth of research done exploring the benefits of different types of exercise. Today we will look at ‘aerobic exercise’, ‘resistance exercise’, ‘isometric resistance training’ and ‘high intensity interval training’ and how these different approaches can help to control blood pressure.

Aerobic exercise is probably the most popular and well-known form of exercise which utilises the heart and lungs; common aerobic exercises include walking, running, cycling, swimming, rowing and many sporting pursuits. The most amount of research has been done in this area and there is convincing evidence to support aerobic exercise in the prevention and treatment of hypertension. There is typically a dose-response relationship with the amount of aerobic exercise performed and the direct effect on improving blood pressure control and even a small increase of physical activity from sedentary levels corresponds with a reduction in blood pressure.

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Resistance exercise involves exercises targeting muscular strength where a muscle works against an opposing resistance (think push-up, step-up, squat, weight training, etc.). There is less evidence supporting the benefit of resistance exercise to lower and control blood pressure and additionally what research has been done is more conflicting. Nonetheless available data suggests moderate intensity resistance exercise is safe and can be effective for decreasing blood pressure in the otherwise healthy adult population. It is important to think about breathing naturally when performing resistance exercise as breath-holding has been associated with a rapid rise in blood pressure which can be potentially harmful.

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The effect of Isometric Resistance Training (IRT) on blood pressure has also been studied and there is evidence supporting the use of this type of exercise for lowering blood pressure. IRT involves using a muscle against an immovable force (e.g. pushing hand in an upwards direction into desk, planks, wall sit, etc.). Along with the other forms of exercise already mentioned, the American Heart Association recommends that IRT be used as an adjunct treatment for hypertension.

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High intensity interval training (HIIT) involves alternating periods of high intensity aerobic exercise with periods of low intensity aerobic exercise or rest between intervals. HIIT has been the buzz word in the field of exercise physiology over the past few years with a great deal of research revealing the benefits to multiple aspects of health and fitness. Blood pressure can be officially added to this list. Studies have shown that, similar to moderate intensity continuous training, HITT has been found to decrease both systolic and diastolic blood pressure to the extent that is known as a ‘clinically significant reduction’.

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Summary

High blood pressure (hypertension) is one of the most common problems encountered in the medical setting.

It is well established that the right type and amount of exercise can reduce blood pressure, placing less stress on the heart and leading to a decreased risk of adverse cardiovascular health events (e.g. heart attack, stroke). Research supports the use of aerobic exercise, resistance exercise, isometric resistance training and high intensity interval training to lower blood pressure.

If you have a sedentary lifestyle, we advise that you prioritise speaking with your GP before commencing a structured exercise routine. We certainly recommend that an assessment with your GP precedes any exercise that is of a high intensity nature.

If you need guidance and are keen to learn how to best manage your blood pressure, see Simon or Jarrod, our Exercise Physiologists to discuss a simple exercise plan.

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References

1 Sharman, JE, Smart, NA, Coombes, JS & Stowasser, M 2019, ‘Exercise and sports science Australia position stand update on exercise and hypertension’, Journal of Human Hypertension, vol. 10, no. 1, pp. 1-7.