Exercise reduces blood pressure as much as medication
If you have high blood pressure, the effect of exercise is just as great as the effect of blood pressure lowering medication. Especially the combination of endurance training and strength training can significantly lower blood pressure. English and American scientists report this in the British Journal of Sports Medicine. The researchers traced 391 previously published trials, aggregated the outcomes of the studies, and analyzed them again.
The researchers found 197 trials in which researchers had studied the effect on the blood pressure of walking, jogging, swimming, strength training or other forms of exercise. They also found 194 trials in which the researchers looked at the effect of 5 different types of antihypertensive drugs.
There were no trials that directly compared the effect of exercise with the effect of medication.
The effects of isometric training were disappointing, the effects of endurance training and strength training were not. The effect of these two exercise modalities on systolic blood pressure is, as you can see below, modest but of the same order as the effect of blood pressure lowering drugs.
The most effective is a combination of strength and endurance training, which lowers the systolic blood pressure by 9 mmHg. In real life situations this may often not be sufficient to replace blood pressure medication, although the effect will probably allow the dose of the medication to be reduced.
High doses of drugs generally work slightly better than phyisical exercise, but if you only look at people with high blood pressure [with a systolic blood pressure above 140 mmHg], then physical activity works just as well as medication.
"Our findings confirm modest but consistent reductions in systolic blood pressure in many studied exercise interventions across all populations, but individuals receiving medications generally achieved greater reductions than those following structured exercise regimens", summarize the researchers.
"Assuming equally reliable estimates, the systolic blood pressure-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications."
Br J Sports Med. 2018 Dec 18. pii: bjsports-2018-099921.
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