Exercise may be as effective as taking prescribed drugs to tackle high blood pressure, a study claims.However, the researchers from the London School of Economics and Political Science in the UK caution patients against giving up their blood pressure lowering drugs in favour of an exercise regimen yet.
The study, published in the British Journal of Sports Medicine, suggests that patients should boost their physical activity levels, alongside their medication.Exercise can lower systolic blood pressure—the amount of pressure in the arteries when the heart is beating and expressed as the top number in any blood pressure reading.However, how exercise compares with blood pressure lowering drugs are not clear.To get round this, the researchers pooled the data from 194 clinical trials looking at the impact of drugs on lowering systolic blood pressure and 197 trials looking at the impact of structured exercise, and involving a total people.Structured exercise was categorised as: endurance, to include walking, jogging, running, cycling and swimming, and high intensity interval training; dynamic resistance, to include strength training—for example, with dumbbells or kettle bells; isometric resistance, such as the static push-up (plank); and a combination of endurance and resistance.Three sets of analyses were done: all types of exercise compared with all classes of blood pressure lowering drugs; different types of exercise compared with different types of drug; and different intensities of exercise compared with different drug doses.Finally, these analyses were repeated, but in a group of exercise trials that included only participants with high blood pressure, as most of these trials were of young healthy participants with normal blood pressure.
The results showed that blood pressure was lower in people treated with drugs than in those following structured programmes.However, when the analyses were restricted to those with high blood pressure, exercise seemed to be just as effective as most drugs. The effectiveness of exercise increased the higher the threshold used to define high blood pressure—that is, anything above 140 mm Hg.The researchers also found “compelling evidence that combining endurance and dynamic resistance training was effective in reducing systolic blood pressure.” However, structured exercise trials were fewer and smaller than those for drugs, they caution.The researchers point out that prescriptions for drugs to lower blood pressure have risen sharply in recent years. This trend is likely to continue given that major clinical practice guidelines have recently lowered the threshold for high systolic blood pressure to 130 mm Hg.However, substituting exercise for drugs may be challenging as people with high blood pressure often have several long term conditions, and an estimated 40 per cent of adults in the US and many European countries are physically inactive, researchers said.”We don’t think, on the basis of our study, that patients should stop taking their antihypertensive medications,” said Huseyin Naci, of London School of Economics and Political Science.”But we hope that our findings will inform evidence based discussions between clinicians and their patients,” he said.
