Abstract
In Japan, there were an estimated 43 million patients with hypertension in 2010. The management of this condition is given the highest priority in disease control, and the importance of lifestyle changes for the prevention and treatment of hypertension has been recognized in Japan. In particular, emphasis has been placed on increasing the levels of activities of daily living and physical exercise (sports). In this literature review, we examined appropriate exercise prescriptions (e.g., type, intensity, duration per session, and frequency) for the prevention and treatment of hypertension as described in Japanese and foreign articles. This review recommends safe and effective whole-body aerobic exercise at moderate intensity (i.e., 50–65% of maximum oxygen intake, 30–60 min per session, 3–4 times a week) that primarily focuses on the major muscle groups for the prevention and treatment of hypertension. Resistance exercise should be performed at low-intensity without breath-holding and should be used as supplementary exercise, but resistance exercise is contraindicated in patients with hypertension who have chest symptoms such as chest pain.
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References
Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH2019). Hypertens Res. 2019;42:1235–481.
Miura K, Nagai M, Ohkubo T. Epidemiology of hypertension in Japan. Circ J. 2013;77:2226–31.
Moraes-Silva IC, Mostarda CT, Silva-Filho AC, Irigoyen MC. Hypertension and exercise training: evidence from clinical studies. In: Xiao J, editors. Exercise for cardiovascular disease prevention and treatment, advances in experimental medicine and biology 1000. Singapore: Springer Nature; 2017. p. 65–84.
Nutrition survey section, Health department of the Ministry of Health, Labor and Welfare. The results of national health and nutrition survey 2017. Tokyo, The Ministry of Health, Labor and Welfare; 2018; 1–33. (Japanese)
He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implication for public health. J Hum Hypertens. 2002;16:761–70.
Socks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344:3–10.
Dickinson HO, Mason JM, Nicolson DJ, Campbell F, Beyer FR, Cook JV, et al. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006;24:215–33.
Nakamura K, Okamura T, Hayakawa T, Hozawa A, Kadowaki T, Murakami Y, et al. The proportion of individuals with alcohol-induced hypertension among total hypertensives in a general Japanese population: NIPPON DATA90. Hypertens Res. 2007;30:663–8.
Leiter LA, Abbott D, Campbell NRC, Mendelson R, Ogilvie RI, Chockalingam A. Recommendations on obesity and weight loss. CMAJ. 1999;160(9 Suppl):S7–12.
Hackam DG, Khan NA, Hemmelgarn BR, Rabkin SW, Touyz RM, Campbell NR, et al. The 2010 Canadian hypertension education program recommendations for the management of hypertension. Part 2-therapy. Can J Cardiol. 2010;26:249–58.
Diaz KM, Shimbo D. Physical activity and the prevention of hypertension. Curr Hypertens Rep. 2013;15:659–68.
Cleroux J, Feldman RD, Petrella RJ. Recommendations on physical exercise training. CMAJ. 1999;160(9 Suppl):S21–2.
Wang L, Ai D, Zhang N. Exercise dosing and prescription-playing it safe: dangers and prescription. In: Xiao J, editor. Exercise for cardiovascular disease prevention and treatment, advances in experimental medicine and biology 1000. Singapore, Springer Nature; 2017; 357–87.
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59.
Sharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with hypertension. Am J Hypertens. 2015;28:147–58.
Izdebska E, Cybulska I, Izdebski J, Makowiecka-Ciesla M, Trzebski A. Effects of moderate physical training on blood pressure variability and hemodynamic pattern in mildly hypertensive subjects. J Physiol Pharm. 2004;55:713–24.
Hansen D, Niebauer J, Cornelissen V, Barna O, Neunhaeuserer D, Stettler C, et al. Exercise prescription in patients with different combinations of cardiovascular disease risk factors: a consensus statement from the EXPERT working group. Sports Med. 2018;48:1781–97.
Hackam DG, Khan NA, Hemmelgarn BR, Rabkin SW, Touyz RM, Campbell NR, et al. The 2010 Canadian hypertension education program recommendations for the management of hypertension: part 2–therapy. Can J Cardiol. 2010;26:249–58.
Armstrong LE, Brubaker PH, Whaley MH, Otto RM. ACSM’s Guidelines for Exercise Testing and Prescription (7th ed.), In: Whaley MH, Senior editor. Philadelphia, Lippincott Williams & Wilkins; 2005, p. 366.
Colberg-Ochs SR, Ehrman JK, Johann J, Kokkinos P, Pack PQ, Lignor G. Chapter 10: Exercise prescription for individuals with metabolic disease and cardiovascular disease risk factors. In: Riebe D, senior editor. ACSM’s Guidelines for Exercise Testing and Prescription (10th ed.), Philadelphia, Lippincott Williams & Wilkins; 2018; 279–83.
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Sakamoto, S. Prescription of exercise training for hypertensives. Hypertens Res 43, 155–161 (2020). https://doi.org/10.1038/s41440-019-0344-1
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DOI: https://doi.org/10.1038/s41440-019-0344-1
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