Hypertension and Exercise Training: Evidence from Clinical Studies

Abstract

Hypertension is a worldwide prevalent disease, mostly manifested as its primary ethiology, characterized by a chronic, multifactorial, asymptomatic, and usually incurable state. It is estimated that more than one billion of the world population is hypertensive. Also, hypertension is the main cause of the two most frequent causes of death worldwide: myocardial infarction and stroke. Due to the necessity of the cardiovascular system to manage chronically increased levels of blood pressure, hypertension causes severe alterations in multiple organs, as the heart, vessels, kidneys, eyes and brain, thus increasing the risk of health complications. The heart is the main target organ and suffers several adaptations to compensate the increased blood pressure levels; nevertheless, long-term adaptations without proper control are extremely harmful to cardiovascular health. On the other hand, hypertension is a modifiable risk factor and its adequate control is highly dependent on lifestyle. Pharmacological treatment is of great success when adherence is high. Several classes of antihypertensive drugs are prescribed and can effectively maintain blood pressure within acceptable levels. However, non-pharmacological methods, as diet and exercise training, can not only optimize the treatment but also prevent or postpone hypertension development as well as its complications, acting as important complements to the ideal control of elevated blood pressure, and bringing together benefits beyond blood pressure decrease, as a general health status improvement and increased quality of life. There is consistent evidence that regular exercise training promotes several benefits when properly prescribed and practised, acting as "medicine" for dozens of chronic diseases. The effects of exercise training in blood pressure levels and in its mechanisms of control are of clinical relevance and efficacy. This chapter will describe the classical and recent results on the beneficial effects of different modalities of exercise training in the cardiovascular system of human primary hypertension, focusing on the mechanisms influenced by exercise training which help to decrease blood pressure and improve the cardiovascular system.

Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension

“…Therefore, blood pressure management plays an important role in the prevention of cerebrovascular disease in patients with hypertension. Antihypertensive therapy, dietary modification, and exercise are standard strategies for management of hypertension [ 5 , 6 ]. However, approximately 50% of patients receiving treatment for hypertension were unable to accomplish the target blood pressure goal as defined by guidelines for hypertension [ 7 , 8 ].…”

Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression

“…Regarding the results by users and nonusers of antihypertensive drugs, both showed signi cant and similar reductions in SBP and DBP, emphasizing that aerobic training also has great hypotensive potential, being able to further optimize the treatment of hypertension, reducing the risks of complications and improving the clinical picture of hypertensive patients 56 .…”

Effects of exercise on cellular and tissue aging

“…The effect of exercise amongst the population with established CV events is also beneficial. After a myocardial infarction, exercise has been shown to prevent future complications, improve the quality of life and longevity of patients [ 33 ]. Amongst older adults with heart failure and preserved ejection fraction, exercise training is the most effective intervention to improve functional outcomes.…”