Effectiveness of Aerobic Exercise on Hypertension

BY Anam Hamid(Doctor of Physiotherapy)               

Effectiveness of Aerobic Exercise on Hypertension

Abstract

Hypertension is characterized by persistently raised pressure in the blood vessels. Blood Pressure 140/90 is considered to be hypertensive. Hypertension can lead to various notorious complications in the body. It is a review article and the objective of this article is to study the effectiveness of aerobic training on hypertension. Google Scholar, PubMed were used for the literature search. Lifestyle modification such as exercise (aerobic exercise) is really helpful in controlling hypertension. Aerobic training whether of upper or lower limb despite its intensity reduces blood pressure. Aerobic Training helps in decreasing the blood pressure by an estimate of 5 mm Hg to 7 mm Hg. Hypertensive patients should indulge in the aerobic activity of 30-50 min daily.

Key Words: Aerobic Training, Exercise, Hypertension, Blood Pressure, Hypertensive.

Introduction

Hypertension is known as high blood pressure. Hypertension is the utmost world health concern because of its universality and associated risk of various other diseases. Hypertension has many risk factors that include age, family history, taking too much sodium in the diet, being an overweight and sedentary lifestyle, stress and alcohol consumption that leads the way to very notorious effects such as heart attack, chronic kidney disease and cerebrovascular accident (Cao et al., 2019).  Systolic blood pressure 140 mm, Hg and Diastolic blood pressure 90 mm Hg is considered to be the hypertensive values. Endurance training helps in reducing the BP by an estimate of 5 mm Hg to 7 mm Hg. Certain parameters for the exercise such as intensity, frequency, the duration must be set according to desirable goals (Pescatello, 2005).

Incidence

Incidence of hypertension is high in elderly individuals as compared to adults. The occurrence of hypertension is increasing comprehensively with an estimate of about 30% increase in pervasiveness by the year 2025 (SARKI et al., 2015).

Methods

Google Scholar, PubMed, CINAHL Database are used for literature search. The search terms and search strategy was “Hypertension” OR “High Blood Pressure” AND “Aerobic Exercise” OR “Aerobic Training” OR “Endurance Training”.

Discussion

Treatment guideline for hypertension has been changed from medicative to the daily lifestyle transformation because the medicative treatment cost is increasing day by day (Cornelissen & Smart, 2013). According to European and American hypertension guidelines, regular physical exercise is very beneficial in treating or managing hypertension. Physical activity helps in decreasing hypertension that does not respond well to medical treatment. Hypertensive patients should engross themselves with aerobic exercise daily for about 40 minutes. Aerobic exercises include dancing, walking, swimming, jogging, treadmill, stair climbing (Dimeo et al., 2012). Aerobic exercises help in lowering the blood pressure of the body. Aerobic exercises appear to be more effective in reducing blood pressure as compared to the muscle-building exercises (Pagonas et al., 2017). Primary hypertension can cause severe disturbances in the body. An aerobic training program with different strengths can also reduce blood pressure. Power walking helps in decreasing the overall immensity of BP rise during exercise in aged people and thus reducing the risk for other circulatory system incidents (He et al., 2018). Endurance training not only helps in reducing resting blood pressure but also decreases the ambulatory blood pressure. Endurance exercises decrease BP by decreasing circulatory resistance (Cornelissen & Fagard, 2005). People who are hypertensive (especially elderly) and unable to perform lower limb aerobic exercises due to various complications can perform upper limb aerobic exercises. Upper limb aerobic exercises include various arm exercises like arm cycling really helps in decreasing both systolic and diastolic blood pressure (Westhoff et al., 2008).

Aerobic exercise and Post Exercise Hypertension (PEH)

Recent Researches suggest that 30-60 min of aerobic activity for 4-7 days a week besides the tasks of daily life helps to control hypertension. Post-exercise hypotension (PEH) is produced after performing aerobic exercise. It is mostly congruously developed in prehypertension and hypertension people. The extent to which post-exercise hypertension develops determines the degree to which blood pressure will be lowered after aerobic activity. Overall the advantageous effect of endurance training improves the accruing risk profile of a patient (Millar & Goodman, 2014). Aerobic Exercise despite its intensity helps in reducing post-exercise blood pressure but high-intensity exercise spell will induce appreciable blood pressure reduction as compared to the low-intensity exercise spell (Eicher et al., 2010).

Aerobic Exercise vs Antihypertensive Drugs

The pharmacological treatment for hypertension is slightly expensive and has some side effects like cough, dizziness, nausea, lack of energy. Because of these reasons the non-pharmacological management gained light. Strenuous aerobic activity of 2 miles per day helps in decreasing blood pressure in hypertensives and this physical activity also helps in weight reduction. Acute and chronic both types of hypertension are controlled by aerobic activity (Cade et al., 1984). In patients who are taking 2 antihypertensive drugs to control BP, aerobic exercise must be combined with the pharmacological therapy to decrease the frequency of antihypertensive drugs. Aerobic dancing was really helpful in decreasing blood pressure in patients who were using 2 antihypertensive drugs. This activity will prevent them from 3 antihypertensive drugs for controlling hypertension and will increase the constancy of patients for pharmacological management (Maruf et al., 2016).In patients with poor BP control, aerobic activity along with the pharmacological management will intensify the BP control rate with the same amount of drug. Aerobic activity may supplement the effect of antihypertensive drugs thus decreasing their dose (Maruf et al., 2014).

Aerobic Training affect on Renal Function

People with essential hypertension also show some abnormalities in their renal function. The abnormalities not only affect the body fluid but also disturb the responsiveness to dietary sodium that increases the blood pressure. Aerobic training does not improve the renal function and thus not helps in managing hypertension by decreasing the renal sensitivity to dietary sodium. Although there was a reduction in blood pressure by aerobic exercise no change in renal function was observed (Dengel et al., 2006). Aerobic exercise also reduces the blood pressure at rest in postmenopausal women with hypertension as most of this population presents with the complaint of hypertension. No change in another body mechanism (renal function, body weight) controlling BP was observed. The intensity and duration of the aerobic activity were set in accordance that it can be easily performed by inactive middle-aged and declining age women with hypertension (Seals et al., 1997).

Water Aerobic Training

Water aerobic training helps in reducing systolic and mean arterial pressure in hypertensive patients. This type of training is mostly recommended for those people who are obese and for those who have orthopaedic problems because water exerts marginal stress on the body and is very relieving (Farahani et al., 2010). Water aerobic training decreases the systolic blood pressure but not the diastolic blood pressure in morbidly obese women (Cunha et al., 2016).

Conclusion

The best non-pharmacological treatment to hypertension is lifestyle modification. Exercise is really helpful in reducing blood pressure. Aerobic exercises reduce blood pressure by decreasing cardiovascular resistance. 30 to 40 minutes of exercise for approximately 6 days a week is mandatory in managing hypertension. Aerobic exercise increases the rate of control of antihypertensive drugs. Aerobic exercise decreases blood pressure in postmenopausal hypertensive females. Thus aerobic training helps manage blood pressure in hypertensive people of all ages irrespective of its intensity, duration and type.

Author's Details

Anam Hamid (Doctor of Physiotherapy).

Government college university Faisalabad, Pakistan.

Reviewed & Edited by

Saima jabbar1, Dr. Amna Khalid 2

1 M.Phil Scholar,2 Research Officer

1.Department of Physiotherapy, University of Lahore.

2 College of Physiotherapy, GC University, Faisalabad.

References

Cade, R., Mars, D., Wagemaker, H., Zauner, C., Packer, D., Privette, M., ... & Hood-Lewis, D. (1984). Effect of aerobic exercise training on patients with systemic arterial hypertension. The American journal of medicine, 77(5), 785-790.

Cao, L., Li, X., Yan, P., Wang, X., Li, M., Li, R., ... & Yang, K. (2019). The effectiveness of aerobic exercise for hypertensive population: A systematic review and meta‐analysis. The Journal of Clinical Hypertension, 21(7), 868-876.

Cornelissen, V. A., & Fagard, R. H. (2005). Effects of endurance training on blood pressure, blood pressure–regulating mechanisms, and cardiovascular risk factors. Hypertension, 46(4), 667-675.

Cornelissen, V. A., & Smart, N. A. (2013). Exercise training for blood pressure: a systematic review and meta-analysis. Journal of the American Heart Association, 2(1), e004473.

Cunha, R. M., Arsa, G., Neves, E. B., Lopes, L. C., Santana, F., Noleto, M. V., ... & Lehnen, A. M. (2016). Water aerobics is followed by short-time and immediate systolic blood pressure reduction in overweight and obese hypertensive women. Journal of the American Society of Hypertension, 10(7), 570-577.

Dengel, D. R., Brown, M. D., Reynolds, T. H., Kuskowski, M. A., & Supiano, M. A. (2006). Effect of aerobic exercise training on blood pressure sensitivity to dietary sodium in older hypertensives. Journal of human hypertension, 20(5), 372-378.

Dimeo, F., Pagonas, N., Seibert, F., Arndt, R., Zidek, W., & Westhoff, T. H. (2012). Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension, 60(3), 653-658.

Eicher, J. D., Maresh, C. M., Tsongalis, G. J., Thompson, P. D., & Pescatello, L. S. (2010). The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension. American heart journal, 160(3), 513-520.

Farahani, A. V., Mansournia, M. A., Asheri, H., Fotouhi, A., Yunesian, M., Jamali, M., & Ziaee, V. (2010). The effects of a 10-week water aerobic exercise on the resting blood pressure in patients with essential hypertension. Asian journal of sports medicine, 1(3), 159.

He, L. I., Wei, W. R., & Can, Z. (2018). Effects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study. Clinical and Experimental Hypertension, 40(7), 673-679.

Maruf, F. A., Akinpelu, A. O., Salako, B. L., & Akinyemi, J. O. (2016). Effects of aerobic dance training on blood pressure in individuals with uncontrolled hypertension on two antihypertensive drugs: a randomized clinical trial. Journal of the American Society of Hypertension, 10(4), 336-345.

Maruf, F. A., Salako, B. L., & Akinpelu, A. O. (2014). Can aerobic exercise complement antihypertensive drugs to achieve blood pressure control in individuals with essential hypertension?. Journal of Cardiovascular Medicine, 15(6), 456-462.

Millar, P. J., & Goodman, J. M. (2014). Exercise as medicine: Role in the management of primary hypertension. Applied Physiology, Nutrition, and Metabolism, 39(7), 856-858.

Pagonas, N., Vlatsas, S., Bauer, F., Seibert, F. S., Zidek, W., Babel, N., ... & Westhoff, T. H. (2017). Aerobic versus isometric handgrip exercise in hypertension: a randomized controlled trial. Journal of hypertension, 35(11), 2199-2206.

Pescatello, L. S. (2005). Exercise and hypertension: recent advances in exercise prescription. Current hypertension reports, 7(4), 281-286.

Sarki, A. M., Nduka, C. U., Stranges, S., Kandala, N. B., & Uthman, O. A. (2015). Prevalence of hypertension in low-and middle-income countries: a systematic review and meta-analysis. Medicine, 94(50).

Seals, D. R., Silverman, H. G., Reiling, M. J., & Davy, K. P. (1997). Effect of regular aerobic exercise on elevated blood pressure in postmenopausal women. The American journal of cardiology, 80(1), 49-55.

Westhoff, T. H., Schmidt, S., Gross, V., Joppke, M., Zidek, W., van der Giet, M., & Dimeo, F. (2008). The cardiovascular effects of upper-limb aerobic exercise in hypertensive patients. Journal of hypertension, 26(7), 1336-1342.