Physical Activity and the Prevention of Hypertension
- 1.8k Downloads
As the worldwide prevalence of hypertension continues to increase, the primary prevention of hypertension has become an important global public health initiative. Physical activity is commonly recommended as an important lifestyle modification that may aid in the prevention of hypertension. Recent epidemiologic evidence has demonstrated a consistent, temporal, and dose-dependent relationship between physical activity and the development of hypertension. Experimental evidence from interventional studies has further confirmed a relationship between physical activity and hypertension as the favorable effects of exercise on blood pressure reduction have been well characterized in recent years. Despite the available evidence strongly supporting a role for physical activity in the prevention of hypertension, many unanswered questions regarding the protective benefits of physical activity in high-risk individuals, the factors that may moderate the relationship between physical activity and hypertension, and the optimal prescription for hypertension prevention remain. We review the most recent evidence for the role of physical activity in the prevention of hypertension and discuss recent studies that have sought to address these unanswered questions.
KeywordsPhysical activity Exercise Hypertension Prevention Blood pressure Resistance training Endurance training
This work was supported by a National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) Diversity Supplement awarded to Keith M. Diaz (P01-HL047540-19S1).
Compliance with Ethics Guidelines
Conflict of Interest
Keith M. Diaz declares that he has no conflict of interest.
Daichi Shimbo has received grants from NIH.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 24.US Department of Health and Human Services. 2008 Physical activity guidelines for Americans: Be active, healthy, and happy! 2008. http://www.health.gov/paguidelines/. Accessed 10 June 2013.
- 26.• Pavey TG, Peeters G, Bauman AE, Brown WJ. Does vigorous physical activity provide additional benefits beyond those of moderate? Med Sci Sports Exerc. 2013; doi: 10.1249/MSS.0b013e3182940b91. This large prospective study assessed whether vigorous physical activity provides additional benefits in the prevention of hypertension above those that accrue from moderate intensity physical activity. Interestingly, they report that vigorous physical activity does not provide additional benefits in the prevention of hypertension above those from moderate intensity activity alone. PubMedGoogle Scholar
- 27.•• Williams PT, Thompson PD. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Arterioscler Thromb Vasc Biol. 2013;33:1085-91. This highly publicized, large propsective study provides some of the best available answers to the important question as to what intensity of exercise is required to reduce hypertension risk. Using data jointly from National Runners’ Health Study II and the National Walkers’ Health Study investigators report that walking and running provide similar risk reductions for the prevention of hypertension. PubMedCrossRefGoogle Scholar
- 36.• Shook RP, Lee DC, Sui X, Prasad V, Hooker SP, Church TS, et al. Cardiorespiratory fitness reduces the risk of incident hypertension associated with a parental history of hypertension. Hypertension. 2012;59:1220-4. This prospective study is the first to demonstrate the protective effects of physical activity among a population with a family history of hypertension, suggesting that physical activity could mitigate any genetic predisposition to hypertension development. PubMedCrossRefGoogle Scholar
- 41.Williams MA, Haskell WL, Ades PA, Amsterdam EA, Bittner V, Franklin BA, et al. Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2007;116:572–84.PubMedCrossRefGoogle Scholar
- 42.• Maslow AL, Sui X, Colabianchi N, Hussey J, Blair SN. Muscular strength and incident hypertension in normotensive and prehypertensive men. Med Sci Sports Exerc. 2010;42:288-95. This study is the first propsective study to investigate the relationship between muscular strength (an attribute developed from resistance training) and incident hypertension. Investigators report that men in the high-strength group had a lower risk for incident hypertension. Interaction analyses further showed that for each level of cardiorespiratory fitness higher levels of muscular strength provided additive protection against the development of hypertension, suggesting that supplementing aerobic exercise with resistance training may be beneficial in the prevention of hypertension. PubMedCrossRefGoogle Scholar
- 45.•• Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2:e004473. This systematic review and meta-analysis provides the most up-to-date information on the effects of exercise training on blood pressure among published randomized controlled trials. Investigators comprehensively review the effects of aerobic exercise training, resistance training, and combined training among all hypertension subgroups. PubMedCrossRefGoogle Scholar
- 51.Åstrand P-O, Rodahl K. Textbook of work physiology: physiological bases of exercise. 2nd ed. McGraw-Hill series in health education, physical education, and recreation. New York: McGraw-Hill; 1977.Google Scholar
- 58.Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JM, Guimaraes GV. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res. 2010;33:836–43.PubMedCrossRefGoogle Scholar