High blood pressure is one of the most common health problems that adults are diagnosed with. In fact, hypertension affects 25% of the world’s population. Risk factors for hypertension include:
· Advancing age
· A family history of high blood pressure
· Excessive use of alcohol
· Lack of physical activity
As you might expect, diet is a factor that impacts blood pressure too. Studies show that the DASH diet (The Dietary Approaches to Stop Hypertension) is linked with a reduction in blood pressure, likely because it’s a diet rich in minerals like potassium, magnesium, and calcium that help lower blood pressure. In one study, the DASH diet lowered systolic blood pressure by an average of 6 mmHg and diastolic blood pressure by 4 mmHg relative to a typical American diet. The DASH diet emphasizes fruits, vegetables, whole grains, low-fat dairy, nuts, poultry, and fish.
Why is it so important to bring elevated blood pressure down? Over time, high blood pressure can lead to serious health complications. These include:
· Heart failure
· Coronary artery disease
· Chronic kidney disease
Exercise and Blood Pressure Medications
We often hear that exercise is medicine but how does it compete with blood pressure medications for controlling blood pressure? The results might surprise you. A recent study published in the British Journal of Sports Medicine pooled the results of 194 different studies looking at the impact of exercise on blood pressure. The study included almost 40,000 people, a respectable number.
The analysis focused on the impact of various types of exercise on blood pressure, including aerobic exercise, high-intensity interval training, and resistance training using a variety of forms of resistance from weights to body weight exercises. They also looked at the effects of various types of blood pressure drugs on blood pressure control.
The results? People with hypertension, defined by systolic blood pressure readings over 140 mmHg, who exercised experienced similar reductions in blood pressure as those who took blood-pressure lowering medications. But overall, blood pressure was still lower in those on medications. In the study, aerobic exercise and dynamic resistance training stood out as being the most blood pressure friendly.
If exercise can lower blood pressure as much as a pill, does this mean you should toss your blood pressure medications and exercise to reduce your blood pressure? It’s too early to say this. First, there needs to be randomized-controlled studies directly comparing exercise versus blood pressure medications for blood pressure control. What it suggests is that exercise is an excellent add-on for blood pressure control. Plus, exercise has heart health benefits that extend beyond blood pressure.
The Heart Health Benefits of Exercise
Aerobic exercise lowers blood pressure by its impact on the inner wall of arteries. The inside wall of well-behaving arteries produces a gas called nitric oxide. In turn, nitric oxide dilates or opens up the arterial wall wider and this lowers blood pressure. Aerobic exercise boosts the release of nitric oxide from the artery wall so that blood pressure drops and the artery behaves more like a healthy artery.
Exercise also, over time, makes the heart a stronger pump. When you’re aerobically conditioned, your heart pumps more blood with each heartbeat. As such, it doesn’t have to beat as many times per minute to supply muscles and other tissues with blood and oxygen. That’s why aerobic exercise often causes a drop in resting heart rate over time. It’s not uncommon for an athlete to have a resting heart rate in the 40s or 50s. The athlete’s heart has become more efficient at pumping blood due to their training.
Aerobic exercise even changes the structure of your heart. The heart muscle thickens over time, including the left ventricle, the portion that pumps blood to your body. A thicker left ventricle means your heart can deliver greater blood and oxygen delivery with each beat. If you were to stop exercising for a long period of time, the heart muscles would return to its pre-exercise size as you no longer need the extra blood and oxygen delivery. Your heart, like the rest of your body, is a master at adapting to its environment!
Aerobic exercise also improves how cells handle glucose. When you do a workout, cells take up glucose easier. Exercise actually boosts the number of GLUT-4 receptors on the surface of muscle cells. These are receptors that take up glucose without the need for insulin. That’s why exercise is especially important for people with pre-diabetes or diabetes. We know that diabetes is a strong risk factor for cardiovascular disease as well. In fact, having diabetes doubles the risk of dying of a heart attack or stroke. People with diabetes tend to get heart disease earlier in life too.
Another way exercise lowers the risk of heart disease and high blood pressure is by reducing sympathetic nervous system activity. Think of the sympathetic nervous system as the “fight or flight” portion that gets you geared up to fight a battle or run away. But too much sympathetic nervous system activity is harmful to heart health. It speeds up your heart rate and raises your blood pressure. You don’t want it to constantly be “on.” Exercise helps subdue the sympathetic nervous system a bit. It also helps relieve stress.
The Bottom Line
Exercise is as good for your blood vessels as it is for your heart. Studies even show that a single exercise session causes a blood pressure drop that lasts for several hours afterward. But the key is to be consistent with your training. Don’t toss your blood pressure medications but use exercise as an adjuvant for blood pressure control. The added perk is that it also improves the health of your heart!
Science Daily. “Exercise may be as effective as prescribed drugs to lower high blood pressure”
British Journal of Sports Medicine, 2018; bjsports-2018-099921 DOI: 10.1136/bjsports-2018-099921.
Harvard Gazette. “Exercise changes structure of heart”
Arq Bras Cardiol. 2016 May; 106(5): 422–433.
National Institute of Diabetes, Digestive, and Kidney Diseases. “Diabetes, Heart Disease, and Stroke”
UptoDate.com. “Overview of Hypertension in Adults”
Mayo Clinic. “DASH diet: Healthy eating to lower your blood pressure”