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Exercise measures up to medication as antihypertensive therapy: its value has long been underestimated
  1. Linda S Pescatello
  1. Correspondence to Dr Linda S Pescatello, Department of Kinesiology, University of Connecticut, Storrs CT 06269, USA; linda.pescatello{at}uconn.edu

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Hypertension is the major risk factor for cardiovascular disease (CVD)—the leading global cause of death.1 2 High systolic blood pressure (SBP) is the top health risk factor for the global burden of disease.2 3 The CVD mortality and morbidity benefits of antihypertensive medications are well established, and their use to treat hypertension is increasing worldwide.4 5 These trends will continue as the American Heart Association (AHA) and American College of Cardiology (ACC) recently established lower blood pressure (BP) thresholds for treatment.6

Exercise: one of the best non-pharmacological treatments

Exercise was rated in the AHA/ACC report as one of the best non-pharmacological approaches to treat hypertension because aerobic exercise training lowers BP 5–8 mm Hg among adults with hypertension.6 7 The magnitude of these BP reductions may lower CVD risk by 4%–22% and stroke by 6%–41%,4 8 and reduce the resting BP of adults with hypertension into normal ranges. Accordingly, professional organisations from around the world recommend adults with hypertension participate in 30–60 min/day of moderate to vigorous intensity aerobic exercise, such as walking or jogging, on most days of the week with the recommendations for resistance training less consistent9 (table 1).

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Table 1

Professional Committee Exercise Recommendations for Hypertension (adapted from Pescatello et al 9)

Despite the well documented BP benefits of medications and exercise to treat hypertension, the 2018 Physical Activity Guidelines Advisory Committee (PAGAC) noted in their …

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