By Jonathon Stavres MS, ACSM-EP-C
Hypertension is a disease characterized by a resting systolic blood pressure of 140 mmHg or greater, a diastolic blood pressure of 90 mmHg or greater, or a combination of both. According to the Centers for Disease Control and Prevention, twenty-nine percent of adults in the United States are diagnosed with hypertension, and nearly half of those diagnosed do not have their blood pressure under control.
Common treatment methods for hypertension include drugs such as angiotensin receptor inhibitors (ACE inhibitors), beta-blockers (such as metoprolol), or diuretics. Dietary recommendations are also common for those with hypertension and generally revolve around reducing sodium intake.
Light aerobic exercise is recommended
Finally, light aerobic exercise is recommended to treat hypertension. There is some debate among clinicians as to whether exercise should be prescribed as a first-line treatment, or in conjunction with drug therapy. One of the benefits of using exercise as a treatment is the immediate fall in blood pressure after just one session, also known as post-exercise hypotension.
The exact mechanisms that cause post-exercise hypotension are not fully understood, however, it is well documented that after a moderate to vigorous bout of aerobic exercise blood pressure will drop and remain low for hours after exercise has ended.
Jones et. al research study compared the effects of intensity and total work performed while cycling on post-exercise hypotension. In this study, participants cycled under three trials. One of the trials was a high-intensity trial (70% VO2max ) that lasted thirty minutes. The other two trials were performed with the same workload (40% VO2max), one lasted thirty minutes and the other lasted long enough that the same total work (resistance x frequency x total distance cycled) was performed as in the high-intensity trial.
This protocol allowed researchers to partition the effects of intensity (a product of resistance and frequency) and total work performed. Results indicated that the high-intensity trail, and the trial that was matched for total work performed during the high-intensity trial both caused significant reductions in blood pressure post-exercise. Furthermore, there were no significant differences between these trials. The results from this study indicate that the total work performed during an aerobic exercise trial is more important than intensity for eliciting post-exercise hypotension.
What does this mean for the average person?
This means that you may not necessarily need to make your exercise session more difficult in order to achieve the benefits of post-exercise hypotension. Instead, you can lengthen the duration of your exercise session to increase the total work performed.
Lowering blood pressure one session at a time is the first step in improving chronic blood pressure control. Regular exercise leads to improved vascular function, increased stroke volume, and a lower resting heart rate. The research reviewed shows how you can achieve those goals one step at a time.
*For more examples of other variations/exercises look under Multimedia-VDF Exercise Tips
**Consult with a physician and/or medical healthcare provider before starting any exercise regimen
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Article’s Resources
Nwankwo, T., Yoon, S.S., Burt, V., & Gu, Q. (2013). Hypertension among adults in the US: National Health and Nutrition Examination Survey, 2011-2012.NCHS Data Breif, No. 133. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept of Health and Human Services
Jones, H., George, K., Edwards, B. (2007). Is the magnitude of acute post-exercise hypotension mediated by exercise intensity or total work done? European Journal of Applied Physiology, 102(1). 33-40. doi: 10.1007/s00421-007-0562-0