A program of regular exercise and weight loss is an effective, drug-free treatment for elevated blood pressure in mildly to moderately obese individuals, according to a study in the August 18 issue of Hypertension: Journal of the American Heart Association.
Blood pressure is measured as systolic pressure (when the heart is contracted) over diastolic pressure (when the heart is at rest), both in units of millimeters of mercury (mmHg). A reading of up to 130 over 85 is considered normal. A blood pressure reading of 130 to 139 systolic over 85 to 89 diastolic is the “high normal” range. A person with systolic pressure from 140 to 159 mmHg and diastolic pressure from 90 to 99 mmHg is said to have stage 1 hypertension.
Reducing blood pressure through exercise and weight loss could move many people from stage 1 hypertension into the “high normal” category and many others from “high normal” to “normal,” according to study author Anastasia Georgiades, Ph.D., of Duke University Medical Center.
Participants in this Duke University Medical Center study were sedentary, moderately overweight adults with systolic blood pressure between 130 and 180 mmHg and diastolic blood pressure between 85 and 105 mmHg. They were divided into three groups: exercise only, exercise/weight loss, and a control group. The exercise-only group participated in a supervised exercise program three to four times per week and was instructed to maintain their usual diets. The exercise/weight loss group followed the same exercise regimen, in addition to a program of weekly group weight-loss meetings and reduction of caloric and fat intake. The control group maintained their usual exercise and dietary habits.
After six months, both the exercise/weight loss group and the exercise only group lowered their resting and stress-induced blood pressure levels. Further, the exercise/weight loss group showed a greater reduction in resting and stress-induced diastolic (bottom number) blood pressure than the exercise only group.
While these results are encouraging, they may not apply to everyone. Kenneth Prager, M.D., a clinical professor of medicine at the Columbia University College of Physicians and Surgeons, added another caveat: “This study, which involved patients with ‘high normal’ blood pressure and mild hypertension, cannot be generalized to patients with more severe hypertension, who may need to remain on anti-hypertensive prescription drugs despite a weight loss and exercise program.” Prager is a scientific advisor to the American Council on Science and Health.
The idea that exercise and weight loss can reduce blood pressure is not new: For years physicians have encouraged their inactive hypertensive patients to exercise and lose weight. This report does, however, add to current knowledge in two ways. First, it reinforces, with a carefully controlled study, that exercise and weight loss can lower blood pressure. Second, this study examines what is known as “stress-induced” blood pressure, the blood pressure reading obtained during an activity associated with mental stress, such as giving a public speech or recalling an angry moment. Exaggerated cardiovascular response to mental stress is a risk factor for heart disease. In fact, some physicians say that a high stress-induced blood pressure is more deleterious to a person’s health than a high resting blood pressure.
Prager cautions that those on anti-hypertensive drugs should not immediately throw their medication away and go for a run. “Any reduction or removal of medication must take place under a doctor’s supervision,” he said. For those with stage 1 hypertension or “high normal” blood pressure looking to reduce their blood pressure without the use of drugs, Prager offers this advice: “Consult with your physician about beginning an exercise and weight-loss program such as the one in the study. After a substantial period of time, and as directed by a physician, you may be able to reduce your dependence on anti-hypertensive drugs.”