On March 24, the European Journal of Preventive Cardiology published the first personalized advice on the most effective exercise to lower blood pressure. This ESC consensus document recommends specific activities according to an individual’s current blood pressure level.
One in four heart attacks are caused by high blood pressure. It is estimated that by 2025, around 60% of the world’s population will have hypertension. While it is widely accepted that exercise lowers blood pressure, until now recommendations have focused on the amount of exercise per week, without considering an individual’s starting blood pressure level.
This consensus document used an analysis of the highest quality evidence to produce detailed guidance on how to lower blood pressure in people with hypertension, high-normal blood pressure, and normal blood pressure. For each of the three groups, the paper outlines the first exercise priority for lowering blood pressure, followed by alternatives that still achieve reduction but to a lesser extent.
For people with hypertension (blood pressure of at least 140/90 mmHg), aerobic exercise is the most effective method. This includes activities such as walking, running, cycling or swimming. Blood pressure-lowering effects of aerobic training in hypertension, for example, are in a range comparable to BP-lowering effects reported for antihypertensive drug treatment.
In those with high-normal blood pressure (130–139/85–89 mmHg), dynamic resistance training is the first priority. This refers to strength training typically involving at least six large muscle groups where muscle contraction results in movement – for example, lifting weights, squats, and push-ups.
People with normal blood pressure (less than 130/84 mmHg) benefit most from isometric resistance training (IRT). This involves static contraction of the muscles – for example, the handgrip exercise. An indication for IST in healthy individuals with normal BP may be given, for example, in persons with a family history of hypertension, a history of gestational hypertension, or other reasons for an increased risk of developing hypertension later in life.
For aerobic exercise in hypertensive patients, the expected BP reductions are in the range of −4.9 to −12 mmHg systolic and −3.4 to −5.8 mmHg diastolic. In patients with high-normal BP, dynamic resistance training may provide a BP reduction in the range of −3.0 to −4.7 mmHg systolic and −3.2 to −3.8 mmHg diastolic. The expected BP reduction for IRT In individuals with normal BP is −5.4 to −8.3 mmHg systolic and −1.9 to −3.1 mmHg diastolic.
Источник:
Hanssen H, Boardman H, Deiseroth A, et al. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension.
Eur J Prev Cardiol. 2021. doi:10.1093/eurjpc/zwaa141.
