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Textbook of Sports and Exercise Cardiology pp 719–745Cite as

Impact of Exercise on Cardiovascular Risk Factors: Arterial Hypertension

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Abstract

Hypertension is defined as a systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg or being on antihypertensive treatment. BP in excess of 140/90 mmHg is further categorized in terms of severity. Nearly one billion people in the world have hypertension, causing high BP to be the most important risk factor influencing the global burden of disease. The value of regular physical activity in decreasing blood pressure (BP) and improving several other cardiovascular risk factors has been demonstrated in a large number of studies. For this reason, irrespective of the level of BP, all professional organizations and committees recommend lowering of BP and prevention of hypertension in the first instance by lifestyle changes, including exercise. In this chapter, we will first describe the acute BP response during different types of exercise. Subsequently, we will discuss left ventricular performance and dimensions during a single bout of exercise. We will then provide an overview on the evidence on BP and left ventricular structure and function of exercise therapy in the prevention and management of high BP using data from observational studies and randomized controlled trials. Finally, we will outline some screening and safety measures when implementing exercise programmes in hypertensive individuals.

Keywords

  • Hypertension
  • Blood pressure
  • Dynamic exercise
  • Resistance exercise
  • Physical activity
  • Physical fitness

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Fig. 36.1
Fig. 36.2

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Author information

Authors and Affiliations

  1. Department of Medicine, University of Padua, Padua, Italy

    Paolo Palatini

  2. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium

    Véronique Cornelissen

Authors
  1. Paolo Palatini
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  2. Véronique Cornelissen
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Corresponding author

Correspondence to Paolo Palatini .

Editor information

Editors and Affiliations

  1. Private Center for Sports and Exercise Cardiology, München, Bayern, Germany

    Axel Pressler

  2. University Institute of Sports Medicine Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria

    Josef Niebauer

Review

Review

36.1.1 Questions

  1. 1.

    A female patient aged 56 years presents at your consultation with an office blood pressure of 139/92 mmHg but otherwise healthy with no other co-morbidities or risk factors. Based on the current available evidence, what type, intensity and frequency of exercise would you preferentially prescribe for her?

  2. 2.

    A 48-year-old competitive football player presents at your consultation for a preparticipation cardiovascular screening. His office BP is 148/90 mmHg and in line with a recent measurement by his GP. Otherwise he has a normal resting ECG, no family history of CV disease and no other risk factors. Can he compete?

36.1.2 Answers

  1. 1.

    This patient should be recommended to perform aerobic endurance exercise, at least 5 days per week at a moderate intensity for a total of 150 min per week. Dynamic resistance training at moderate intensity could be added as an adjunct, two times per week.

  2. 2.

    According to current guidelines, this player cannot compete as he has a grade I hypertension. Therefore, lifestyle changes and/or medical therapy are advised. From the moment his BP is controlled (<1 40/85 mmHg) and in the absence of any target organ damage or associated clinical conditions, he can return to competition.

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Palatini, P., Cornelissen, V. (2020). Impact of Exercise on Cardiovascular Risk Factors: Arterial Hypertension. In: Pressler, A., Niebauer, J. (eds) Textbook of Sports and Exercise Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-35374-2_36

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