Miguel Gisbert Personal Trainer – International Mountain Leader

Sports therapy for hypertension.

Many authors advocate sports as a treatment or aid to the treatment of high blood pressure. Some even postulate that the drop in blood pressure of hypertensive patients after sports practice occurs whether it is combined with a healthy lifestyle and a pharmaceutical treatment or not. However, when planning exercises and a training routine for people with this pathology, we are assailed by the doubts and criteria of different sports professionals. We'll try this article to figure out what's better, what's worse, and why.

Why sport in the face of hypertension?

Benefits of sport

It is clear, even today already idle, to mention that sport represents a number of social benefits and the quality of life and general well-being to those who practice it. To mention some of the authors who spoke in the past, distant already, of these benefits we can quote (Wankel & Berger, 1990) who listed them as follows:

We'll focus on the next job on the benefits cardiovascular disease and, in particular, the benefits for hypertension. Despite the fact that other benefits, it is worth noting that they are a part of the more inseparable from the set of enhanced qualities of our organism and which, in many cases, are strongly related. For example, (Jonas, Franks, & Ingram, 1997) establish a relationship between some types of anxiety or depression and the incidence Hypertension. Moreover, as of 1985 (Modan et al., 1985) established a statistical relationship between the obesity and hypertension and, more recently, (Rahmouni, Correia, Haynes, & Mark, 2005) conducted a more obesity causes endothelial dysfunction and alterations in renal function which could be actively involved in the development of Hypertension. That's why the benefits of sport for hypertension should be considered from a global point of view and should be measured using the greater and more varied number of variables possible.

Effects of physical activity on patients with Hypertension

Physical activity has gone from being a counterindicative to recommendation in patients with hypertension (Giannuzzi et al., 2005), which shows that there must be numerous and important reasons for this. One of them is the, already named, obesity. If there is overweight, which is usually a precursor and typical of hypertensives (Study, 2015), this may be reduced after a specific training and thereby favour reducing blood pressure as we've seen before.

Several trials have managed to prove more reducing systolic and diastolic pressure on a group of people hypertensives who performed aerobic training in front of another group of control that didn't do it. As, for example, the one made by (Stewart, Bacher, & Turner, 2005) in which he checked as a 6-month specific resistance training lasting 51 participants between the ages of 55 and 75 with systolic pressures between 130 and 159 mmHg 85 to 99 mmHg was able to reduce diastolic pressure by 2.2 mmHG more than in the control group of 53 equal participants Features. Systolic pressure was also further reduced participants undergoing training than in control, but the difference was not so significant, only 0.8 mmHg. Another observation same study is that trained patients saw their weight reduced and their percentage of body fat.

But this trial is just one more of several with results similars that all demonstrate that the practice of a training specific can help lower blood pressure in patients Hypertensive. The article in (Hamer, Taylor, & Steptoe, 2006) presents a summary of 15 studies more than 10 of which achieved significant reductions in the diastolic pressure after an aerobic resistance training.

On the other hand, cardiovascular disease, among hypertension, are associated with excessive system activity sympathetic nervous (Mueller, 2007), while several studies (VALETTE, COHEN, & HUIDOBRO, 1957), (Zanesco & Antunes, 2007) and (Krieger, Brum, & Negréo, 1998) have been able to see how after prolonged aerobic endurance training levels sympathetic nervous system activity decreases.

Similarly, endothelial dysfunction associated with hypertension could be improved after training due to its influence vasodilator response of the smooth vascular muscle (Westhoff et al., 2007).

In the following figures we can see the mean reductions in systolic (left) and diastolic (right) pressures of 50 trials conducted between 1986 and 2000 (Seamus P. Whelton; Ashley Chin, MPH, MA; Xue Xin, MD, 2002)

How to train?

Previous risks

First, consideration should be given to the possible risks or contraindications that may exist. It's obvious, but never mentionised, that physical activity carries a risk of injury or muscle or joint overload. So all exercises should be directed and revised to be carried out with the best technique and suitability Possible.

The factor to consider most related to the present work is the customer's normal blood pressure. According to the recommendations Of the French Association of Cardiology (Brion & Carré, 2009) the intensity of the French training with people who have higher systolic pressure than 180 mmHg and diastolic greater than 105 mmHg. It should also be taken into account the possibility of thrombus in one of the arteries that could cause some complication. However, statistics say it's not very likely that there will be cardiovascular problems derivatives of the training if it is professionally directed. In a record French cardiac arrest (recovered) per year and after 1.3 millions of hours of workouts. However, they can be more unsupervised activities that can lead to problems cardiac arrests after unsuitable effort or the combination of various heart problems with a possible unlocalized thrombus that causes a death (Parmar, Reeves, & Denney, 2006). So it will be it is essential to perform as deep an analysis as possible of the person treat and adapt training in a way that takes into account all the personal characteristics such as those mentioned above and some others that could also affect the development of training as it could be overweight, smoking, psychosocial state of the client, etc. (Barefoot et al., 1996).

Type of exercise

Four-week trials of mild aerobic workouts exercises such as walking, running, stationary cycling or combinations of previous ones have shown a slight but clinically significant decline in blood pressure (Halbert et al., 1997). In training slightly more intense and prolonged resistance the benefits can be quite reductions of 10.5/7.6 mmHg in systolic pressures and diastolic respectively (Tsai et al., 2004) (Seamus P. Whelton; Ashley Chin, MPH, MA; Xue Xin, MD, 2002). There doesn't seem to be any major differences between conventional resistance training and those of (Kelley & Kelley, 2000).

Isometric work is generally contraindicated for people with hypertension from the possible fluid retention that could cause (Wright, n.d.) and above all because of the risk of heart failure in case of very intense exercises with great isometric effort in which we perform the valve maneuver (apnea period during maximum exertion) generating great pressure (Imholz et al., 1988). However, there are some studies moderate isometric work is recommended without great effort or apnea periods, of course, and which could be very beneficial for elderly people or those with joint ailments can work the different muscle groups without joint overload (Seals et al., 1985) and (JR, TW, & SA, 1987).

The propioceptive and work exercises in imbalance are often offered to older people with hypertension to provide not only an overall well-being and improved physical and blood pressure but also better functional performance. In balance and coordination, thus also helping the fall prevention (Casillas, Gremeaux, Damak, Feki, & Pérennou, 2007).

Intensity and volume.

The effects on lower blood pressure have been observed from relatively low intensity levels maximum capacity of the individual (THOMPSON et al., 2001), therefore they would not be very intense sessions are needed to get these benefits. In fact, the meta-analysis already mentioned (Kelley & Kelley, 2000) shows that you don't get extra benefits in reducing blood pressure by raising the intensity sessions above 70% of the maximum capacity or by increasing the number of sessions per week above 3. Some studies even show not appreciating any difference in the drop in blood pressure after a training with average intensities as to whether the training is conducted with low-intensity sessions (Rogers, Probst, Gruber, Berger, & Boone, 1996), (Moreira, Fuchs, Ribeiro, & Appel, 1999). This is why it is considered recommended a medium to moderate intensity without exceeding the threshold anaerobic or 50% of the maximum lactic capacity (Arakawa, 1999).


Physical activity is generally an effective method for reducing blood pressure in hypertensive patients whether combined with an appropriate lifestyle and relevant medication or not. Sport can bring social and moody benefits to those who practice it that, together with functional and physiological benefits, can increase quality of life and noticeable longevity. Among the types of exercise to be practiced it would be advisable to introduce progressive workouts of 3 sessions per week that include aerobic resistance and functional mobility exercises adapted to each client and with intensities of mild to medium.


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