Blood pressure is an established vital sign given its’ ability to inform clinicians on the status of multiple organ systems in the body. Most commonly, blood pressure is utilized to assess the workload on the cardiovascular system as it maintains circulation to the body under different levels of stress and disease states. Importantly, blood pressure changes can go unnoticed by individuals because significant symptoms are only felt as blood pressure reaches extremes of either low or high blood pressure readings. Authors estimate over 100 million or approximately 1 in 3 Americans have high blood pressure. This is troubling as high blood pressure is a significant risk factor for cardiovascular diseases including stroke and myocardial infarction (heart attack), but is successfully treated with lifestyle changes including diet and exercise, as well as, medications.

Daily aerobic exercise creates beneficial changes in our body most profoundly in our cardiovascular systems including the heart, lungs, arteries, and veins. Consistent exercise creates a more efficient pumping system requiring less work to circulate the blood to our tissues. With increased efficiency the heart is able to beat more slowly and with less force to produce the same output compared to a less efficient system. In a recent systematic review of the available evidence exercise was shown to be as effective at reducing blood pressure as some blood pressure medications. Importantly and stunningly, there is a lack of studies comparing the effect of blood pressure medication to exercise in the same randomized controlled trial.

A recent systematic review was published in the Journal of Medicine and Science in Sport and Exercise on the available evidence behind the utilization of physical activity to both prevent and reduce high blood pressure (Pescatello et al. 2019). In the review they included 17 prior meta analyses and 1 systematic review including a total of over 594,000 adults. Authors reported strong evidence on

• Inverse relationship between activity and development of high blood pressure

• Exercise reduces blood pressure in healthy adults and those with high blood pressure

• Greater reductions in blood pressure are seen in those with higher blood pressure

• Exercise reduces the risk of cardiovascular disease development and progression

Experts report consistent exercise can reduce blood pressure and these reductions can translate in a 20-30% reduction in cardiovascular risk. More recent research shows more intense exercise can create greater reductions in blood pressure. In addition, resistance training has also been shown to have a protective effect on heart health and blood pressure measurements.

The American College of Sports Medicine recommends at risk individuals consult their medical provider before beginning any exercise program. Once cleared for exercise, recommendations include

• Moderate Exercise (40-60% of maximum)

• 30-60 minute bouts (at least 10 minutes for shorter duration, more frequent bouts)

• 150 minutes per week