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Physical activity and supervised exercise among hypertensives and normotensives: status and barriers

  • Dulce Esteves
  • Paulo DuarteEmail author
  • Paulo Pinheiro
  • Rui Brás
  • Ricardo Gouveia Rodrigues
  • Ana Gouveia
  • Kelly O’Hara
Original Article
  • 22 Downloads

Abstract

Purpose

Physical activity (PA) is considered central to hypertension prevention and management. The main purpose of this article is to compare supervised exercise (SE) patterns among hypertensive and normotensive Portuguese adults.

Methods

A total of 966 participants aged between 15 and 90 years old (mean 41.9; SD 19.5) were surveyed face-to-face in public places across Portugal. Participants were considered hypertensives (n = 144) if they have systolic and diastolic blood pressure higher than 160 and 90 mmHg or report taking antihypertensive medication. PA was assessed using the International Physical Activity Questionnaire (IPAQ). Descriptive statistics, Chi-square test for associations and t test for independent samples were used to analyze data.

Results

Hypertensive individuals show a higher prevalence of sedentary lifestyle than normotensive (31% vs 20%). About 40% of hypertensive patients have a high level of physical activity. Several significant differences were found between hypertensives and normotensives regarding the causes for non-participation, information sources and motivation to participate. For infrastructures, only the quality of the equipment (p = 0.032), innovative activities (p = 0.027), and the opportunity to socialize (p = 0.000) are capable of differentiating the two groups.

Conclusions

This study shows the prevalence of sedentary behavior among the hypertensive population. Hypertensives and normotensive behavior reveal different patterns on the barriers, sources of information, and perception regarding the structures. Service providers seem incapable to make hypertensives aware of the risks associated with PA and the benefits associated with SE. More information is needed to make hypertensives aware of the benefits of SE programs.

Keywords

Hypertension Health Physical activity Supervised exercise Program attendance promotion Promotion Information sources Sports health 

Notes

Funding

There is no funding associated with this research.

Compliance with ethical standards

Ethics approval (IRB)

The study protocol conformed to the Declaration of Helsinki and was conducted with the Scientific Committee of Ph.D. Sports Science from the University of Beira Interior approval (no number assigned).

Informed consent

All respondents were unambiguously informed about the study’s objectives, that participation was voluntary, and anonymity was assured. Explicit verbal agreement regarding participation was obtained from all participants before answering the questionnaire.

References

  1. 1.
    Bloch MJ (2016) Worldwide prevalence of hypertension exceeds 1. 3 billion. J Am Soc Hypertens 10:753–754.  https://doi.org/10.1016/j.jash.2016.08.006 CrossRefPubMedGoogle Scholar
  2. 2.
    Chockalingam A, Campbell NR, Fodor JG (2006) Worldwide epidemic of hypertension. Can J Cardiol. 22(7):553–555CrossRefGoogle Scholar
  3. 3.
    Pedersen BK, Saltin B (2015) Exercise as medicine—evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sport 25:1–72.  https://doi.org/10.1111/sms.12581 CrossRefGoogle Scholar
  4. 4.
    Frieden TR, Jaffe MG (2018) Saving 100 million lives by improving global treatment of hypertension and reducing cardiovascular disease risk factors. J Clin Hypertens 20:208–211.  https://doi.org/10.1111/jch.13195 CrossRefGoogle Scholar
  5. 5.
    Williams B, Mancia G, Spiering W et al (2018) 2018 ESC/ESH Guidelines for the management of arterial hypertension. J Hypertens 36:1953–2041.  https://doi.org/10.1097/HJH.0000000000001940 CrossRefPubMedGoogle Scholar
  6. 6.
    Herrod PJJ, Doleman B, Blackwell JEM et al (2018) Exercise and other nonpharmacological strategies to reduce blood pressure in older adults: a systematic review and meta-analysis. J Am Soc Hypertens 12:248–267.  https://doi.org/10.1016/j.jash.2018.01.008 CrossRefPubMedGoogle Scholar
  7. 7.
    Cavalcante PA, Rica R, Evangelista A et al (2015) Effects of exercise intensity on postexercise hypotension after resistance training session in overweight hypertensive patients. Clin Interv Aging 10:1487.  https://doi.org/10.2147/CIA.S79625 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    James PA, Oparil S, Carter BL et al (2014) 2014 evidence-based guideline for the management of high blood pressure in adults. JAMA 311:507.  https://doi.org/10.1001/jama.2013.284427 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Romero Blanco C, Villalvilla Soria DJ, Cabanillas Cruz E et al (2015) Cumplimiento de las recomendaciones de actividad física para la salud en adultos hipertensos. Nutr Hosp 31:415–420.  https://doi.org/10.3305/nh.2015.31.1.7423 CrossRefGoogle Scholar
  10. 10.
    Cornelissen VA, Fagard RH (2005) Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors. Hypertension 46:667–675.  https://doi.org/10.1161/01.HYP.0000184225.05629.51 CrossRefPubMedGoogle Scholar
  11. 11.
    Cornelissen VA, Smart NA (2013) Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc 2:1–9.  https://doi.org/10.1161/JAHA.112.004473 CrossRefGoogle Scholar
  12. 12.
    Schultz MG, La Gerche A, Sharman JE (2017) Blood pressure response to exercise and cardiovascular disease. Curr Hypertens Rep 19:1–7.  https://doi.org/10.1007/s11906-017-0787-1 CrossRefGoogle Scholar
  13. 13.
    Gliemann L, Buess R, Nyberg M et al (2015) Capillary growth, ultrastructure remodelling and exercise training in skeletal muscle of essential hypertensive patients. Acta Physiol 214:210–220.  https://doi.org/10.1111/apha.12501 CrossRefGoogle Scholar
  14. 14.
    Nyberg M, Gliemann L, Hellsten Y (2015) Vascular function in health, hypertension, and diabetes: effect of physical activity on skeletal muscle microcirculation. Scand J Med Sci Sport 25:60–73CrossRefGoogle Scholar
  15. 15.
    Eckel RH, Jakicic JM, Ard JD et al (2014) 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American college of cardiology/American heart association task force on practice guidelines. J Am Coll Cardiol 63:2960–2984.  https://doi.org/10.1016/j.jacc.2013.11.003 CrossRefPubMedGoogle Scholar
  16. 16.
    Piepoli MF, Hoes AW, Agewall S et al (2016) 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Atherosclerosis 252:207–274.  https://doi.org/10.1016/j.atherosclerosis.2016.05.037 CrossRefPubMedGoogle Scholar
  17. 17.
    Dopheide JF, Rubrech J, Trumpp A et al (2017) Supervised exercise training in peripheral arterial disease increases vascular shear stress and profunda femoral artery diameter. Eur J Prev Cardiol 24:178–191.  https://doi.org/10.1177/2047487316665231 CrossRefPubMedGoogle Scholar
  18. 18.
    McDermott MM, Polonsky TS (2016) Home-based exercise—a therapeutic option for peripheral artery disease. Circulation 134:1127–1129.  https://doi.org/10.1161/CIRCULATIONAHA.116.023691 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Motlagh Z, Hidarnia A, Kaveh MH, Kojuri J (2017) Effect of theory-based training intervention on physical activity and blood pressure in hypertensive patients: a randomized control trial. Iran Red Crescent Med J.  https://doi.org/10.5812/ircmj.55610 CrossRefGoogle Scholar
  20. 20.
    Arboix A, Roig H, Rossich R et al (2004) Differences between hypertensive and non-hypertensive ischemic stroke. Eur J Neurol 11:687–692.  https://doi.org/10.1111/j.1468-1331.2004.00910.x CrossRefPubMedGoogle Scholar
  21. 21.
    Craig CL, Marshall AL, Sjöström M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395.  https://doi.org/10.1249/01.MSS.0000078924.61453.FB CrossRefPubMedGoogle Scholar
  22. 22.
    Hagströmer M, Oja P, Sjöström M (2006) The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr 9:755–762.  https://doi.org/10.1079/PHN2005898 CrossRefPubMedGoogle Scholar
  23. 23.
    Thomas N, Alder E, Leese GP (2004) Barriers to physical activity in patients with diabetes. Postgrad Med J 80:287–291.  https://doi.org/10.1136/pgmj.2003.010553 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Pinheiro P, Esteves D, Brás R (2012) Effect of internet and social networks on knowledge regarding physical activity. Int J Manag Sci Technol Inf 4:29–41Google Scholar
  25. 25.
    Al-Zalabani A, Saeed A, Al-Hamdan N (2012) Comparative study of physical activity of hypertensives and normotensives: a cross-sectional study of adults in Saudi Arabia. J Fam Community Med 19:162.  https://doi.org/10.4103/2230-8229.102315 CrossRefGoogle Scholar
  26. 26.
    Nair SP, Ganu SS, Farhnin I (2017) Impact of kinesiophobia on physical activity in patients with arterial hypertension. Int J Health Sci Res 7:170–175Google Scholar
  27. 27.
    Riegel GR, Martins GB, Schmidt AG et al (2019) Self-reported adherence to physical activity recommendations compared to the IPAQ interview in patients with hypertension. Patient Prefer Adherence 13:209–214.  https://doi.org/10.2147/ppa.s185519 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Martins LCG, Guedes NG, Teixeira IX et al (2011) Physical activity level in people with high blood pressure. Rev Lat Am Enfermagem 17:462–467.  https://doi.org/10.1590/s0104-11692009000400005 CrossRefGoogle Scholar
  29. 29.
    Thompson PD, Franklin BA, Balady GJ et al (2007) Exercise and acute cardiovascular events. Circulation 115:2358–2368.  https://doi.org/10.1161/CIRCULATIONAHA.107.181485 CrossRefPubMedGoogle Scholar
  30. 30.
    Pagliaro P, Penna C (2017) Hypertension, hypertrophy, and reperfusion injury. J Cardiovasc Med 18:131–135.  https://doi.org/10.2459/JCM.0000000000000435 CrossRefGoogle Scholar
  31. 31.
    Wienert J, Kuhlmann T, Fink S et al (2017) Motivational and volitional correlates of physical activity in participants reporting no, past, and current hypertension: findings from a cross-sectional observation study. Int J Behav Med 24:908–914.  https://doi.org/10.1007/s12529-017-9649-0 CrossRefPubMedGoogle Scholar
  32. 32.
    Gong J, Xu Y, Chen X et al (2018) Persistent effect at 30-month post intervention of a community-based randomized trial of KM2H2in reducing stroke and heart attack among senior hypertensive patients. Int J Behav Nutr Phys Act 15:1–12.  https://doi.org/10.1186/s12966-017-0635-3 CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Maiorana AJ, Williams AD, Askew CD et al (2018) Exercise professionals with advanced clinical training should be afforded greater responsibility in pre-participation exercise screening: a new collaborative model between exercise professionals and physicians. Sport Med 48:1293–1302.  https://doi.org/10.1007/s40279-018-0888-2 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Universidade da Beira Interior, Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD)CovilhãPortugal
  2. 2.Research Unit in Business Sciences (NECE)Universidade da Beira InteriorCovilhãPortugal
  3. 3.Instituto de Biofísica e Engenharia Biomédica, Faculdade de CiênciasUniversidade da Beira Interior, Universidade de LisboaCovilhãPortugal

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