Resistance exercise for the management of arterial hypertension: An intervention that works

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 23; no. 5; pp. 987 - 989
• Main Author: Ribeiro, Fernando
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.05.2021; John Wiley and Sons Inc; Wiley
• Subjects: Aerobics; Antihypertensives; Blood Pressure; Diuretics; Drugs; Enzymes; Exercise; Female; Fitness training programs; Gender differences; Humans; Hypertension; Hypertension - therapy; Intervention; Lifestyle Interventions; Lifestyles; Meta-analysis; Middle age; Pharmacists; Physical fitness; Prevention; Resistance Training; Tea; Women
• DOI: 10.1111/jch.14197
• ISSN: 1524-6175

Despite progress in awareness, prevention, and treatment, hypertension remains a major public health issue and the most common preventable cause of cardiovascular disease and all-cause mortality. 1 The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 estimated that high systolic blood pressure accounted for 10.4 million deaths and 218 million disability-adjusted life-years worldwide. 1 Over the last decades, the population growth and aging has increased the prevalence of hypertension dramatically; the number of adults with elevated blood pressure doubled from 1975 (594 million) to 2015 (1.13 billion) 2 and is estimated to reach 1.56 billion by 2025. 3 Lifestyle interventions and drug treatment are well-established strategies to lower blood pressure. 4,5 Lifestyle measures comprehend salt restriction, moderation in alcohol intake, healthy diet, smoking cessation, weight loss (goal is ideal body weight), and regular physical activity. 4,5 Interestingly, successful lifestyle changes may delay or prevent the need for drug therapy in patients with grade 1 hypertension, and also improve the effects of antihypertensive drugs. 5 Yet, despite the unquestionable benefits of nonpharmacological lifestyle-oriented interventions, most patients with hypertension will also require drug treatment. 5 In the current issue of the journal, Taati and colleagues 6 explore the topic of lifestyle interventions to lower blood pressure in a group of women with high-normal/stage 1 hypertension. [...]there is compelling evidence supporting the benefits of exercise training to prevent and treat several diseases in both men and women, yet women are often underrepresented in exercise medicine and sports research, creating significant knowledge gaps on sex differences in responses to exercise. 7 Additionally, men and women seem to respond differently to dynamic resistance exercise training. 8,9 By enrolling only women in this study, the authors are providing important information on the blood pressure response to dynamic resistance exercise in this population. In 2016, a meta-analysis (64 controlled studies, 71 interventions; n = 2344) determining if dynamic resistance exercise alone could lower blood pressure to the level reported with aerobic exercise showed that dynamic resistance exercise programs reduced systolic and diastolic blood pressure by −5.7 / −5.2 mm Hg among adults with hypertension. 21 Similar results were later reported in a network meta-analysis showing a −7.2 mm Hg (95% CI: −10.7 to −3.87) decrease in systolic blood pressure as a result of dynamic resistance exercise interventions in adults with hypertension. 17 The magnitude of the ambulatory systolic blood pressure reduction reported in the Taati and colleagues 6 study is impressive, especially since they enrolled women with blood pressure at baseline close to “normal” (office systolic blood pressure of the resistance exercise group: 135 mm Hg).