Exercise and hypertension

Our lifestyle• Physical inactivity can have serious

implications for people's health, said the World Health Organization (WHO).

• Approximately 2 million deaths per year are attributed to physical inactivity, prompting WHO to issue a warning that a sedentary lifestyle could very well be among the 10 leading causes of death and disability in the world.Cardiovascular disdase risk

• Sudden Cardiac Death

Obesity disease• Hypertension

Osteoporosis• Neurocognitive disease

PHYSICAL INACTIVITY

Percentage of population that makes 4-7 days per week, 1-3, or any intense physical activity by

countries

Hypertension• A condition present when blood

flows through the blood vessels with a force greater than normal. Also called high blood pressure. Hypertension can strain the heart, damage blood vessels, and increase the risk of heart attack, stroke, kidney problems, and death. (PubMed Health Glossary)

How is blood pressure

measured?A blood pressure measurement has two parts—a top (first) number and a bottom (second) number. The top number is the “systolic” pressure and the bottom number is the “diastolic”.• Systolic pressure is your blood pressure when your

heart beats and pumps blood through your arteries. Your blood pressure is higher while your heart is pumping, so the systolic number is higher.

• Diastolic pressure is your blood pressure in between heartbeats when your heart is not pumping. Your blood pressure is lower while your heart is not pumping, so the diastolic number is lower.

How is blood pressure measured?

Your blood pressure numbers are given one on top of the other, with your systolic pressure “over” your diastolic pressure.• A normal blood pressure is less than “120 over

80,” or 120/80. This means the systolic pressure is 120 and the diastolic pressure is 80.

• A blood pressure between 120/80 and 139/89 is called “prehypertension”. This means that your blood pressure is higher than normal and that you are at risk for having high blood pressure.

• If your blood pressure is 140/90 or higher most of the time it is measured, you have high blood pressure.

Systolicmm Hg

Diastolicmm Hg

Normal <120 and <80

Prehypertension 120-139 or 80-89

Hypertension I 140-159 or 90-99

Hypertension II >160 or >100

Crisis of hypertension (emergency attention is needed)

>180 or >100

Hypertension level

How common is high blood pressure?

• High blood pressure is a common, chronic (ongoing) health condition.

• High blood pressure affects adults of all ages, but especially those over age 65.

• Around 76.4 million people in the United States have high blood pressure.

As a result of hypertension… (Campbell et al., 2014)

• Increased blood pressure was the cause of an estimated 9.4 million deaths and 162 million years of life lost in 2010 and the cause of:

• 50% of heart disease, stroke, and heart failure.• 18% of deaths overall and more than 40% of deaths in people

with diabetes.• Hypertension is a leading risk for fetal and maternal death in

pregnancy, dementia, and renal failure.

• Hypertension is a public health epidemic.• Approximately 4 in 10 adults older than 25 years have

hypertension, and in many countries another 1 in 5 have prehypertension.

• An estimated 9 of 10 adults living to 80 years will develop hypertension.

• One half of BP-related disease occurs in people with higher levels of BP even within the normal range.

Consequences of hypertension

• High blood pressure can lead to the thickening of the arterial walls, to reduce stress on the walls and oxygen demand.

• This thickening causes its lumen, or conduit for the passage of blood, reduces its diameter.

• For this reason, the heart must work harder to pump blood through the narrowed artery openings.

Consequences of hypertension

• As a result, the heart responds to increasing your muscle mass (left ventricular hypertrophy) to deal with that overstrain.

• This increase in muscle mass ends up being harmful because it is not accompanied by an equivalent increase in blood flow and may lead heart attack and renal failure. In addition, the heart muscle becomes more irritable and more arrhythmias are produced.

Exercise and hypertension

• Palatini et al. (2009), found that people with hypertension who were regular physical exercise had less risk of left ventricular hypertrophy.

• In addition the sedentary people had greater volume and thickness of the walls of the left ventricle.

• Ptisavos et al (2011), found that 16 weeks of aerobic exercise had favorable effects on the structure and left ventricular mass in 40 people with hypertension.

It seems that the response to the exercise depends on its intensity,

type, frequency and duration.

Benefits• Physical activity is beneficial to reduce the

overall risk of death and of death by cardiovascular accident.

• Physical activity can prevent hypertension and decrease their levels in already hypertensive people.

Aerobic training, dynamic and isometric strength training and combined

training appears to have beneficial effects on the diastolic and the systolic (less training combined in the latter).

References• Campbell, N. R., Lackland, D. T., & Niebylski, M. L. (2014). High blood

pressure: why prevention and control are urgent and important—a 2014 fact sheet from the World Hypertension League and the International Society of Hypertension. The Journal of Clinical Hypertension, 16(8), 551-553.

• Eisenberg, J. (2012). Measuring Your Blood Pressure at Home. PubMed Health, from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0041082/#conssmbp.s3

• European commission. (2005). Health and food, from: http://ec.europa.eu/public_opinion/archives/ebs/ebs_246_en.pdf

• Palatini, P., & Julius, S. (2009). The role of cardiac autonomic function in hypertension and cardiovascular disease. Current hypertension reports, 11(3), 199-205.

• World Health Organization (2002). Physical inactivity a leading cause of disease and disability, from: http://www.who.int/mediacentre/news/releases/release23/en/