Abstract
Hypertension is one of the most important cardiovascular disease risk factors due to its high prevalence and significant medical costs. The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and the American College of Sports Medicine recommend lifestyle modifications such as habitual physical activity as initial therapy to prevent, treat, and control hypertension. The purposes of this chapter are to: (1) overview the current consensus on the effects of acute (immediate, short-term, or postexercise hypotension) and chronic (long-term or training) aerobic exercise on blood pressure among individuals with hypertension; (2) discuss new and emerging research on the effects of acute and chronic aerobic exercise on blood pressure that has the potential to alter the way in which aerobic exercise is prescribed to prevent, treat, and control hypertension in the future; and (3) present exercise prescription recommendations and special considerations for individuals with hypertension that consider this new and emerging research.
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- 1-RM:
-
One repetition maximum
- ACSM:
-
American College of Sports Medicine
- BP:
-
Blood pressure
- DBP:
-
Diastolic blood pressure
- Ex Rx :
-
Exercise prescription
- FITT:
-
Frequency, Intensity, Time, and Type
- JNC 8:
-
The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
- HR:
-
Heart rate
- HIIT:
-
High intensity interval training
- PEH:
-
Postexercise hypotension
- RPE:
-
Rating of perceived exertion
- SBP:
-
Systolic blood pressure
- US:
-
United States
- VO2max :
-
Maximal oxygen consumption
- VO2peak :
-
Peak oxygen consumption
- VO2reserve :
-
Oxygen consumption reserve
References
Mozaffarian D, Benjamin EJ, Go AS, et al. Executive summary: heart disease and stroke statistics-2015 update: a report from the American heart association. Circulation. 2015;131(4):434–41.
Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123:933–44.
Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
Fields LE, Burt VL, Cutler JA, Hughes J, Roccella EJ, Sorlie P. The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 2004;44:398–404.
Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164:2126–34.
Staessen JA, Wang JG, Birkenhager WH. Outcome beyond blood pressure control? Eur Heart J. 2003;24:504–14.
Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011–2012. NCHS Data Brief. 2013;133:1–8.
James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–20.
Pescatello LS, Franklin BA, Fagard R, et al. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc. 2004;36:533–53.
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report. National Institutes of Health. Obes Res 1998;6 Suppl 2:51S–209S.
Johnson BT, Macdonald HV, Bruneau Jr ML, et al. Methodological quality of meta-analyses on the blood pressure response to exercise: a review. J Hypertens. 2014;32:706–23.
Brandao Rondon MU, Alves MJ, Braga AM, et al. Postexercise blood pressure reduction in elderly hypertensive patients. J Am Coll Cardiol. 2002;39:676–82.
Kenney MJ, Seals DR. Postexercise hypotension. Key features, mechanisms, and clinical significance. Hypertension. 1993;22:653–64.
Pescatello LS. Exercise and hypertension: recent advances in exercise prescription. Curr Hypertens Rep. 2005;7:281–6.
Fitzgerald W. Labile hypertension and jogging: new diagnostic tool or spurious discovery? Br Med J (Clin Res Ed). 1981;282:542–4.
Haskell WL. J.B. Wolffe Memorial Lecture. Health consequences of physical activity: understanding and challenges regarding dose-response. Med Sci Sports Exerc. 1994;26:649–60.
Hecksteden A, Grutters T, Meyer T. Association between postexercise hypotension and long-term training-induced blood pressure reduction: a pilot study. Clin J Sport Med. 2013;23:58–63.
Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG. Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc. 2012;44:1644–52.
Pescatello LS, Kulikowich JM. The aftereffects of dynamic exercise on ambulatory blood pressure. Med Sci Sports Exerc. 2001;33:1855–61.
Wilcox RG, Bennett T, Brown AM, Macdonald IA. Is exercise good for high blood pressure? Br Med J (Clin Res Ed). 1982;285:767–9.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151:W65–94.
Johnson BT, Eagly AH. Meta-analysis of social-personality psychological research. In: Reis T, Judd CM, editors. Handbook of research methods in social and personality psychology. 2nd ed. London: Cambridge University Press; 2014.
Bennett T, Wilcox RG, Macdonald IA. Post-exercise reduction of blood pressure in hypertensive men is not due to acute impairment of baroreflex function. Clin Sci (Lond). 1984;67:97–103.
Cleroux J, Kouame N, Nadeau A, Coulombe D, Lacourciere Y. Aftereffects of exercise on regional and systemic hemodynamics in hypertension. Hypertension. 1992;19:183–91.
Floras JS, Sinkey CA, Aylward PE, Seals DR, Thoren PN, Mark AL. Postexercise hypotension and sympathoinhibition in borderline hypertensive men. Hypertension. 1989;14:28–35.
Floras JS, Hara K. Sympathoneural and haemodynamic characteristics of young subjects with mild essential hypertension. J Hypertens. 1993;11:647–55.
Hagberg JM, Montain SJ, Martin III WH. Blood pressure and hemodynamic responses after exercise in older hypertensives. J Appl Physiol. 1987;63:270–6.
Kraul J, Chrastek J, Adamirova J. The hypotensive effect of physical activity. In: Rabb W, editor. Prevention of ischemic heart disease: principles and practice. Springfield: Charles C Thomas; 1966.
MacDonald JR, Hogben CD, Tarnopolsky MA, MacDougall JD. Post exercise hypotension is sustained during subsequent bouts of mild exercise and simulated activities of daily living. J Hum Hypertens. 2001;15:567–71.
Paulev PE, Jordal R, Kristensen O, Ladefoged J. Therapeutic effect of exercise on hypertension. Eur J Appl Physiol Occup Physiol. 1984;53:180–5.
Pescatello LS, Fargo AE, Leach Jr CN, Scherzer HH. Short-term effect of dynamic exercise on arterial blood pressure. Circulation. 1991;83:1557–61.
Pescatello LS, Guidry MA, Blanchard BE, et al. Exercise intensity alters postexercise hypotension. J Hypertens. 2004;22:1881–8.
Quinn TJ. Twenty-four hour, ambulatory blood pressure responses following acute exercise: impact of exercise intensity. J Hum Hypertens. 2000;14:547–53.
Taylor-Tolbert NS, Dengel DR, Brown MD, et al. Ambulatory blood pressure after acute exercise in older men with essential hypertension. Am J Hypertens. 2000;13:44–51.
Wallace JP, Bogle PG, King BA, Krasnoff JB, Jastremski CA. The magnitude and duration of ambulatory blood pressure reduction following acute exercise. J Hum Hypertens. 1999;13:361–6.
Bhammar DM, Angadi SS, Gaesser GA. Effects of fractionized and continuous exercise on 24-h ambulatory blood pressure. Med Sci Sports Exerc. 2012;44:2270–6.
Ciolac EG, Guimaraes GV, D'Avila VM, Bortolotto LA, Doria EL, Bocchi EA. Acute aerobic exercise reduces 24-h ambulatory blood pressure levels in long-term-treated hypertensive patients. Clinics (Sao Paulo). 2008;63:753–8.
Ciolac EG, Guimaraes GV, D Avila VM, Bortolotto LA, Doria EL, Bocchi EA. Acute effects of continuous and interval aerobic exercise on 24-h ambulatory blood pressure in long-term treated hypertensive patients. Int J Cardiol. 2009;133:381–7.
Ciolac EG. High-intensity interval training and hypertension: maximizing the benefits of exercise? Am J Cardiovasc Dis. 2012;2:102–10.
Guidry MA, Blanchard BE, Thompson PD, et al. The influence of short and long duration on the blood pressure response to an acute bout of dynamic exercise. Am Heart J 2006;151:1322.e5–12.
Eicher JD, Maresh CM, Tsongalis GJ, Thompson PD, Pescatello LS. The additive blood pressure lowering effects of exercise intensity on post-exercise hypotension. Am Heart J. 2010;160:513–20.
Angadi SS, Weltman A, Watson-Winfield D, et al. Effect of fractionized vs continuous, single-session exercise on blood pressure in adults. J Hum Hypertens. 2010;24:300–2.
Jones H, Taylor CE, Lewis NC, George K, Atkinson G. Post-exercise blood pressure reduction is greater following intermittent than continuous exercise and is influenced less by diurnal variation. Chronobiol Int. 2009;26:293–306.
Miyashita M, Burns SF, Stensel DJ. Accumulating short bouts of running reduces resting blood pressure in young normotensive/pre-hypertensive men. J Sports Sci. 2011;29:1473–82.
Lacombe SP, Goodman JM, Spragg CM, Liu S, Thomas SG. Interval and continuous exercise elicit equivalent postexercise hypotension in prehypertensive men, despite differences in regulation. Appl Physiol Nutr Metab. 2011;36:881–91.
Padilla J, Wallace JP, Park S. Accumulation of physical activity reduces blood pressure in pre- and hypertension. Med Sci Sports Exerc. 2005;37:1264–75.
Park S, Rink L, Wallace J. Accumulation of physical activity: blood pressure reduction between 10-min walking sessions. J Hum Hypertens. 2008;22:475–82.
Park S, Rink LD, Wallace JP. Accumulation of physical activity leads to a greater blood pressure reduction than a single continuous session, in prehypertension. J Hypertens. 2006;24:1761–70.
Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc. 2001;33:S484–92; discussion S493–4.
Hagberg JM, Brown MD. Does exercise training play a role in the treatment of essential hypertension? J Cardiovasc Risk. 1995;2:296–302.
Hagberg JM, Park JJ, Brown MD. The role of exercise training in the treatment of hypertension: an update. Sports Med. 2000;30:193–206.
Staessen JA, Gasowski J, Wang JG, et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet. 2000;355:865–72.
Pescatello LS, Riebe D, Arena R. ACSM’s guidelines for exercise testing and prescription. 9th ed. Baltimore: Lippincott Williams & Wilkins; 2013.
Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59.
Swain DP, Franklin BA. Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. Am J Cardiol. 2006;97:141–7.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): final report. Circulation. 2002;106(25):3143–421.
Ash GI, Eicher JD, Pescatello LS. The promises and challenges of the use of genomics in the prescription of exercise for hypertension: the 2013 update. Curr Hypertens Rev. 2013;9:130–47.
Bouchard C, Blair SN, Church TS, et al. Adverse metabolic response to regular exercise: is it a rare or common occurrence? PLoS One. 2012;7:e37887.
Fagard RH. Physical activity in the prevention and treatment of hypertension in the obese. Med Sci Sports Exerc. 1999;31:S624–30.
Kelley GA, Kelley KA, Tran ZV. Aerobic exercise and resting blood pressure: a meta-analytic review of randomized, controlled trials. Prev Cardiol. 2001;4:73–80.
Cornelissen VA, Fagard RH. Effect of resistance training on resting blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2005;23(2):251–9.
Cornelissen VA, Buys R, Smart NA. Endurance exercise beneficially affects ambulatory blood pressure: a systematic review and meta-analysis. J Hypertens. 2013;31:639–48.
Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2:e004473.
Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493–503.
Bouchard C, Rankinen T. Individual differences in response to regular physical activity. Med Sci Sports Exerc. 2001;33:S446–51; discussion S452–3.
Ash GI, Macdonald HV, Pescatello LS. Antihypertensive effects of exercise among those with resistant hypertension. Hypertension. 2013;61:e1.
Thompson PD, Crouse SF, Goodpaster B, Kelley D, Moyna N, Pescatello L. The acute versus the chronic response to exercise. Med Sci Sports Exerc. 2001;33:S438–45; discussion S452–3.
Halliwill JR. Mechanisms and clinical implications of post-exercise hypotension in humans. Exerc Sport Sci Rev. 2001;29:65–70.
Maeda S, Tanabe T, Otsuki T, Sugawara J, Ajisaka R, Matsuda M. Acute exercise increases systemic arterial compliance after 6-month exercise training in older women. Hypertens Res. 2008;31:377–81.
Tabara Y, Yuasa T, Oshiumi A, et al. Effect of acute and long-term aerobic exercise on arterial stiffness in the elderly. Hypertens Res. 2007;30:895–902.
Beck DT, Martin JS, Casey DP, Braith RW. Exercise training improves endothelial function in resistance arteries of young prehypertensives. J Hum Hypertens. 2014;28:303–9.
Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590:1077–84.
Heydari M, Boutcher YN, Boutcher SH. High-intensity intermittent exercise and cardiovascular and autonomic function. Clin Auton Res. 2013;23:57–65.
Kessler HS, Sisson SB, Short KR. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Med. 2012;42:489–509.
Molmen-Hansen HE, Stolen T, Tjonna AE, et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol. 2012;19:151–60.
Donnelly JE, Blair SN, Jakicic JM, et al. American College of Sports Medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41:459–71.
Borg GA. Perceived exertion. Exerc Sport Sci Rev. 1974;2:131–53.
Borg G, Ljunggren G, Ceci R. The increase of perceived exertion, aches and pain in the legs, heart rate and blood lactate during exercise on a bicycle ergometer. Eur J Appl Physiol Occup Physiol. 1985;54:343–9.
Borg G, Hassmen P, Lagerstrom M. Perceived exertion related to heart rate and blood lactate during arm and leg exercise. Eur J Appl Physiol Occup Physiol. 1987;56:679–85.
Whelton PK, He J, Appel LJ, et al. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002;288:1882–8.
Allen NA, Jacelon CS, Chipkin SR. Feasibility and acceptability of continuous glucose monitoring and accelerometer technology in exercising individuals with type 2 diabetes. J Clin Nurs. 2009;18:373–83.
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Pescatello, L.S., MacDonald, H.V., Johnson, B.T. (2015). The Effects of Aerobic Exercise on Hypertension: Current Consensus and Emerging Research. In: Pescatello, L. (eds) Effects of Exercise on Hypertension. Molecular and Translational Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-17076-3_1
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