The Place of Exercise in the Treatment of Hypertension

The Place of Exercise in the Treatment of Hypertension
The Place of Exercise in the Treatment of Hypertension

Death rates due to heart diseases are 15% lower in individuals who exercise at moderate or high intensity. In a balanced diet and healthy lifestyle, moderate-intensity dynamic aerobic exercises (walking, cycling, swimming) are recommended for at least 30 minutes and 5-7 days a week for hypertension patients.

Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Cardiology, Dr. Cover. Member Mert Sarılar gave information about 'The importance of exercise in hypertension patients'.

Cardiovascular diseases are the most important cause of death worldwide. Therefore, early diagnosis and appropriate treatment of cardiovascular diseases play a major role in survival. Hypertension is also among the important risk factors for the development of cardiovascular disease. In a study conducted in 2015, approximately 1,13 billion people in the world are thought to have hypertension, and this number is expected to increase to 2025 billion in 1,5. By definition, hypertension is a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more.

Hypertension treatment includes two basic components: lifestyle changes and drug therapy. Lifestyle change and exercise undoubtedly reduce blood pressure in patients, but the majority of patients require additional drug therapy. Studies have shown that a decrease of more than 10 mmHg in systolic blood pressure and more than 5 mmHg in diastolic blood pressure reduces the risk of death by 10-15%.

Lifestyle changes include limiting salt in the diet (maximum 5 g sodium intake per day), quitting smoking and alcohol, eating a Mediterranean type diet rich in fresh vegetables and fruits, brisk walking for 5 hour at least 7-1 days a week, and weight control.

With exercise, a sudden rise in systolic blood pressure occurs first, and then, with a rapid decrease, blood pressure returns to normal levels. Various observational studies have shown that regular aerobic exercise is beneficial in the prevention and treatment of hypertension. In this way, it even reduces the cardiovascular risk.

Exercise types are grouped in 3 categories as aerobic, static-stretching and resistance.

Aerobic exercises are endurance exercises in which large muscle groups participate. Exercises that increase oxygen consumption such as walking, running, cycling and swimming are aerobic exercises. Resistance exercises (lifting weights, etc.) are exercises to increase muscle strength and endurance. Static stretching (Isometric) exercises are performed by bringing the body to a certain position so that the muscle group is stretched.

Aerobic endurance exercises reduce resting systolic blood pressure by 3.5 mmHg and diastolic blood pressure by 2.5 mmHg. In dynamic resistance exercises, a decrease of 1.8 mmHg in systolic blood pressure and 3.2 mmHg in diastolic blood pressure is observed. In static stretching exercises, it was shown that there was a 10.9 mmHg decrease in systolic blood pressure and a 6.2 mmHg decrease in diastolic blood pressure. However, studies in which these benefits are observed may have scientific limitations as the data were obtained by looking at individuals' own measurements. Endurance exercises reduce blood pressure more significantly, especially in patients with hypertension, compared to other exercise types (8.3 mmHg in systolic blood pressure, 5.2 mmHg in diastolic blood pressure).

Unlike exercise type, exercise intensity also shows differences on blood pressure and heart health. For example, low-intensity and short-term exercises lower blood pressure less than moderate or high-intensity exercises. Individuals doing moderate or high-intensity exercise had a 15% lower mortality rate due to heart disease. Based on this study, moderate-intensity dynamic aerobic exercises (walking, cycling, swimming) for at least 30 minutes and 5-7 days a week are recommended for hypertension patients. In addition, resistance exercises 2-3 days a week are also recommended for hypertension patients. The preventive effect of isometric exercise type on heart disease and its effect on blood pressure has not been clearly reported.

The positive effect of exercise on blood pressure and heart health has been demonstrated by many scientific studies, and regular exercise is recommended for all patients, whether they have hypertension or not. However, especially in patients whose blood pressure cannot be controlled with exercise and lifestyle changes, long-term drug therapy and a specialist physician examination are essential.

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