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Exercise is a major lifestyle modification needed to prevent, treat, and control hypertension


from the American College of Sports Medicine (ACSM)

March 2, 2004
For immediate release

Christa Dickey
Jim Gavin

Exercise is a major lifestyle modification needed to prevent, treat, and control hypertension

INDIANAPOLIS  Exercise is the cornerstone therapy for the primary prevention, treatment, and control of hypertension, according to the new Position Stand Exercise and Hypertension released today from the American College of Sports Medicine (ACSM). Adults with hypertension should seek to gain at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week, but they should be evaluated, treated, and monitored closely. The official ACSM pronouncement is published in the March 2004 issue of Medicine & Science in Sports & Exercise®.

Hypertension is a common medical disorder associated with increased risk of disease. It is the most prevalent cardiovascular condition found in recreational exercisers and athletes. Hypertension increases with age, and is higher in young men than in young women, although the reverse is true in older adults. Resting blood pressure (BP), family history, body mass index, and fitness level are known predictors of hypertension.

Exercise programs that involve endurance activities, such as walking, jogging, running, or cycling, coupled with resistance training, help to prevent the development of hypertension and lower BP in adults. Individuals with controlled hypertension and no cardiovascular or kidney disease may participate in an exercise program, although there is limited ability to forecast exercise BP and cardiovascular complications due to possible underlying clinical conditions.

A higher level of physical activity and fitness resulting from long-term (chronic) exercise training has a protective effect against hypertension; that is, fitter people with hypertension will have lower BP than those who are less fit. In addition, those with higher baseline BP levels will experience greater BP reductions from exercise. Even a single session (acute) exercise bout provides an immediate reduction in BP, which can last for a major portion of the day (up to 22 hours).

Older adults experience these same benefits, but the evidence is not clear in children and adolescents. ACSM indicates the rise in childhood obesity will likely lead to increased numbers of hypertensive children and adolescents.

Special considerations for exercise with hypertension include:

" The type, frequency and duration of activity are important. People with hypertension should exercise daily for 30 minutes or more at a moderate level to gain health benefits.

" People using medications, such as beta-blockers, should be cautious of developing heat illness when exercising. These medications and diuretics impair the ability to regulate body temperature.

" Adults with hypertension should extend the cool-down period of the workout. Antihypertensives, such as alpha blockers, calcium channel blockers, and vasodilators may cause BP to lower too much after abruptly ending exercise.

" Overweight and obese adults with hypertension should combine regular exercise and weight loss to effectively lower resting BP.

" Promoting the BP-lowering effects of single exercise sessions may best motivate people to exercise. Physicians are encouraged to promote the role of exercise in controlling BP to their patients.

" A physician evaluation and clearance is necessary for those with severe or uncontrolled BP prior to beginning an exercise program. Higher risk patients (such as those with coronary artery disease or chronic heart failure) should lessen the intensity of their training program.

The paper acknowledges both neural and vascular changes resulting from chronic and acute exercise contribute to decreases in BP, and that there may be a genetic link between these types of exercises and the BP-lowering effects.

ACSMs guidelines support those proposed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, which advocate earlier detection and aggressive treatment as a way to control hypertension-related death and disease and feature a prehypertension category to measure BP.

Exercise and Hypertension replaces ACSMs 1993 Position Stand, Physical Activity, Physical Fitness, and Hypertension.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 International, National, and Regional members are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

NOTE: Medicine & Science in Sports & Exercise® is the official journal of the American College of Sports Medicine, and is available from Lippincott, Williams & Wilkins at 1-800-638-6423. For a complete copy of the Position Stand, visit ACSM online at To speak with a leading sports medicine expert on the topic, contact the Department of Communications and Public Information at 317-637-9200.