Fitness: Use exercise to help keep blood pressure in check

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About one in four Canadian adults have high blood pressure, a statistic that’s likely to get worse as our population continues to age. Considered the No. 1 risk for stroke and a red flag for heart disease, hypertension weakens the arteries, which in turn compromises the flow of oxygen-rich blood from the heart to the rest of the body.

Medication is often the first choice when it comes to moderating blood pressure, but exercise is also frequently prescribed as an effective means of keeping blood pressure in check. The heart health benefits of physical activity are well known and well studied, with plenty of data indicating that regular exercise significantly reduces both systolic (the upper number in a blood pressure reading, which should be 120 or less) and diastolic (the lower number in a blood pressure reading, which should be 80 or less) readings.  

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What’s not completely understood is what types of exercise are the most effective. The Heart and Stroke Foundation recommends 150 minutes of moderate- to vigorous-intensity aerobic exercise per week, in bouts of 10 minutes or more. But given the growing interest in different types of exercise, researchers from Canterbury Christ Church University, U.K., decided to review the newest wave of studies. Their analysis included 270 studies that featured 15,827 participants and several types of exercise (walking, running, cycling, different types of HIIT, resistance training and isometric exercises). 

“The current exercise guideline recommendations are largely based on older data, with recent investigations demonstrating a growing interest in more novel exercise modes, such as high intensity interval training (HIIT) and isometric training, as well as a plethora of new data on the role of independent dynamic resistance training and combined resistance training and aerobic exercise,” said the researchers. 

The good news is that almost all modes of exercise reduced both systolic and diastolic blood pressure readings. The only workout that didn’t have an impact on blood pressure was interval training.

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The other good news is that the study subjects with hypertension benefited from a larger drop in blood pressure than those with normal blood pressure, confirming the effectiveness of exercise in improving the health of those who need it most.  

Isometric exercise training ranked as most effective, followed by combined training (a mix of cardio and weight training), resistance training, cardio and HIIT. And that’s not all: Resistance training is comparable to cardio when it comes to lowering blood pressure, which is a relatively new finding. Also worth noting is that cycling and running are significantly more effective than walking, suggesting that exercise intensity may play a larger role than previously thought.  

It helps to understand the definition of an isometric exercise. Unlike most resistance exercises, where a joint flexes or extends and at least one muscle lengthens and/or shortens, joints don’t move and muscles don’t visibly extend or contract during isometric exercise. The idea is to hold a single position for several seconds — even minutes. A wall sit (stand with your back on the wall and slowly lower your hips until they are level with your knees and hold this position) and plank (lie face down on the floor and prop yourself up on your forearms — elbows under shoulders — and toes, letting the rest of your body hover above the floor and hold) are two examples of isometric exercises that are easy to incorporate into your exercise routine. 

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Isometric exercises don’t require equipment, so you can do them at home. They also require little in the way of instruction and are easy to perform. That doesn’t mean they aren’t challenging. The goal of any isometric exercise is to keep the muscle(s) under tension for an extended period. Just don’t hold your breath, which is the most common mistake made by exercisers struggling to maintain a static position. 

For all you walkers out there, don’t be discouraged by the finding that walking doesn’t rank near the top of the list of workouts most effective at lowering blood pressure. Just a few small tweaks can improve the efficacy of your workout. Boost intensity by opting for shorter, faster walks, versus going long and slow. If that’s too much of a challenge, try incorporating several extended bouts of speedier walking to your regular tour around the neighbourhood. Shorter strides with a faster turnover and a more pronounced arm swing will help you shift into high gear.

Exercisers of any age and fitness level can add more isometric exercises to their routine. Try a plank, wall sit and glute raise (lie on back with knees bent, then lift the hips off the ground and hold), all of which can be done in the gym or at home. It doesn’t take much to make sure your workout has a positive impact on blood pressure, proving once again that exercise is medicine.

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