Impact of exercise modalities on blood pressure control in hypertensive patients

A narrative review

https://doi.org/10.53730/ijhs.v8nS1.14701

Authors

  • Tahchi Abderrahmen Professor Lecturer - B, Institute of Science and Technology of Physical Activities and Sports, University of Constantine 2 – Abdelhamid Mehri, Algeria
  • Hassen Ahmed Chaouki Professor Lecturer - A, Institute of Science and Technology of Physical Activities and Sports, University of Djelfa – Zian Achour, Algeria
  • Ghessier Mehamed Professor Lecturer - B, Institute of Science and Technology of Physical Activities and Sports, University of Djelfa – Zian Achour, Algeria
  • Kharchi Amir Khaled Professor Lecturer - B, Science and Technology of Physical Activities and Sports, University of Setif 2 Mohamed Lamin Debaghine, Algeria
  • Brahimi Rachid Professor Lecturer - B, Institute of Science and Technology of Physical Activities and Sports, University of Djelfa – Zian Achour, Algeria

Keywords:

hypertension, blood pressure regulation, aerobic exercise, resistance training, mind-body exercises, deep breathing exercises

Abstract

Hypertension poses a significant health burden, necessitating effective interventions to manage blood pressure and mitigate associated cardiovascular risks. Exercise has emerged as a cornerstone non-pharmacological strategy in the management of hypertension. This comprehensive review synthesizes current evidence regarding the impact of various exercise modalities on blood pressure regulation in hypertensive individuals. The review commences by elucidating the physiological mechanisms underpinning exercise-induced blood pressure alterations, highlighting factors influencing blood pressure responses during different exercises. It delineates the differential impacts of aerobic and resistance training, examining their effectiveness in blood pressure reduction among diverse populations, considering age, fitness levels, and comorbidities. Moreover, the review explores the emerging prominence of high-intensity interval training (HIIT), showcasing its unique effects on blood pressure regulation and cardiorespiratory fitness improvement compared to traditional continuous aerobic exercises. Additionally, alternative mind-body exercises, including tai chi, qigong, and mindfulness-based interventions, are investigated for their potential to influence blood pressure levels among hypertensive populations. Furthermore, the review identifies novel exercise approaches such as deep breathing exercises and multi-modal isometric exercise training (MIET) as promising strategies for blood pressure control in hypertensive individuals, emphasizing their potential benefits and implications for tailored exercise prescriptions.

Downloads

Download data is not yet available.

References

Agarwal, S., Jain, M., Arora, S., & Sheikher, C. (2022). EFFECTS OF RESISTANCE EXERCISE ON BLOOD PRESSURE IN HYPERTENSIVE PATIENTS OF CENTRAL INDIA: A PROSPECTIVE STUDY. Asian Journal of Pharmaceutical and Clinical Research, 141–142. https://doi.org/10.22159/ajpcr.2022.v15i12.46500

Am, A. I., Ishak, R. B., Putri, A. P., Wahyudi, T., & Rahmasari, I. (2023). Effectiveness of Progressive Muscle Relaxation as Complementary Therapy in Managing Blood Pressure Among Adult with Hypertension. Proceedings of the International Conference on Nursing and Health Sciences, 4(1), 137–142. https://doi.org/10.37287/picnhs.v4i1.1729

Baddeley-White, D. S., Wood, C. N., McGowan, C. L. M., Howden, R., Gaillard, E. C., Gordon, B. D. H., Goss-Sampson, M. A., & Swaine, I. L. (2021). Blood pressure-lowering efficacy of a 6-week multi-modal isometric exercise intervention. Blood Pressure Monitoring, 26(1), 30–38. https://doi.org/10.1097/MBP.0000000000000492

Baffour-Awuah, B., Pearson, M. J., Dieberg, G., & Smart, N. A. (2023). Isometric Resistance Training to Manage Hypertension: Systematic Review and Meta-analysis. Current Hypertension Reports, 25(4), 35–49. https://doi.org/10.1007/s11906-023-01232-w

Baghaiee, B., Dolatabadi Farahani, N., S Pescatello, L., Davaran Hagh, E., & Ebrahimi, K. (2022). The effect of resistance training on blood pressure, apelin, ANP, PON1, adiponectin, H2O2, and ET-1 in hypertensive men. Journal of Shahrekord University of Medical Sciences, 25(1), 30–38. https://doi.org/10.34172/jsums.2023.726

Bhowmik, R., Shaharyar, Md. A., Anand, K., Mazumdar, H., Mandal, A., Mandal, P., Chakraborty, S., Panday, P., & Karmakar, S. (2023). Mechanism of action of drugs used in hypertension. In How Synthetic Drugs Work (pp. 349–367). Elsevier. https://doi.org/10.1016/B978-0-323-99855-0.00015-4

Botzer, A., Finkelstein, Y., & Unger, R. (2021). Blood Pressure Regulation Evolved from Basic Homeostatic Components. Biomedicines, 9(5), 469. https://doi.org/10.3390/biomedicines9050469

Brasileiro-Santos, M. D. S., & Santos, A. D. C. (2017). Neural mechanismsand post-exercise hypotension: The importance of experimental studies. Motriz: Revista de Educação Física, 23(spe). https://doi.org/10.1590/s1980-6574201700si0006

Coelho-Júnior, H. J., Silva Aguiar, S., Calvani, R., Picca, A., De Azevedo Carvalho, D., Rodrigues, B., Zwarg-Sá, J. D. C., Bacurau, R. F., Cesari, M., Marzetti, E., & Uchida, M. C. (2022). Acute and chronic effects of traditional and high-speed resistance training on blood pressure in older adults: A crossover study and systematic review and meta-analysis. Experimental Gerontology, 163, 111775. https://doi.org/10.1016/j.exger.2022.111775

De Barcelos, G. T., Heberle, I., Coneglian, J. C., Vieira, B. A., Delevatti, R. S., & Gerage, A. M. (2022). Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression. Frontiers in Sports and Active Living, 4, 719063. https://doi.org/10.3389/fspor.2022.719063

De Ciuceis, C., Rizzoni, D., & Palatini, P. (2023). Microcirculation and Physical Exercise In Hypertension. Hypertension, 80(4), 730–739. https://doi.org/10.1161/HYPERTENSIONAHA.122.19465

De Moraes, J. A., De Barcelos, G. T., Coneglian, J. C., Do Espírito Santo, B. C. D. R., Delevatti, R. S., & Gerage, A. M. (2022). Combined Training with Aerobic Exercise Performed Outdoors Can Promote Better Blood Pressure and Affective Responses in Individuals with Cardiovascular Risk Factors. International Journal of Environmental Research and Public Health, 19(23), 16009. https://doi.org/10.3390/ijerph192316009

De Souza Mesquita, F. O., Gambassi, B. B., De Oliveira Silva, M., Moreira, S. R., Neves, V. R., Gomes-Neto, M., & Schwingel, P. A. (2023). Effect of High-Intensity Interval Training on Exercise Capacity, Blood Pressure, and Autonomic Responses in Patients With Hypertension: A Systematic Review and Meta-analysis. Sports Health: A Multidisciplinary Approach, 15(4), 571–578. https://doi.org/10.1177/19417381221139343

Edwards, J. J., Taylor, K. A., Cottam, C., Jalaludeen, N., Coleman, D. A., Wiles, J. D., Sharma, R., & O’Driscoll, J. M. (2021). Ambulatory blood pressure adaptations to high-intensity interval training: A randomized controlled study. Journal of Hypertension, 39(2), 341–348. https://doi.org/10.1097/HJH.0000000000002630

Esmailiyan, M., Amerizadeh, A., Vahdat, S., Ghodsi, M., Doewes, R. I., & Sundram, Y. (2023). Effect of Different Types of Aerobic Exercise on Individuals With and Without Hypertension: An Updated Systematic Review. Current Problems in Cardiology, 48(3), 101034. https://doi.org/10.1016/j.cpcardiol.2021.101034

Fagard, R. H., & Cornelissen, V. A. (2007). Effect of exercise on blood pressure control in hypertensive patients. European Journal of Cardiovascular Prevention & Rehabilitation, 14(1), 12–17. https://doi.org/10.1097/HJR.0b013e3280128bbb

Fecchio, R. Y., De Sousa, J. C. S., Oliveira-Silva, L., Da Silva Junior, N. D., Pio-Abreu, A., Da Silva, G. V., Drager, L. F., Low, D. A., & Forjaz, C. L. M. (2023). Effects of dynamic, isometric and combined resistance training on blood pressure and its mechanisms in hypertensive men. Hypertension Research, 46(4), 1031–1043. https://doi.org/10.1038/s41440-023-01202-4

Fisher, J. P., & Secher, N. H. (2019). Regulation of Heart Rate and Blood Pressure During Exercise in Humans. In Muscle and Exercise Physiology (pp. 541–560). Elsevier. https://doi.org/10.1016/B978-0-12-814593-7.00024-4

Fu, Y., Feng, Q., Wei, Y., Fan, L., Pan, Y., Ji, J., & Lin, C. (2022). Meta-Analysis of the Effect of Aerobic Training on Blood Pressure in Hypertensive Patients. Computational and Mathematical Methods in Medicine, 2022, 1–8. https://doi.org/10.1155/2022/9281661

Ge, B., Chen, H., & Liao, X. (2022). The Effect of Mind-Body Exercise on Blood Pressure in Middle-Aged and Elderly Patients with Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine, 2022, 1–18. https://doi.org/10.1155/2022/7984658

Gerage, A. M., Alberton, C. L., Cucato, G. G., Delevatti, R. S., & Ritti-Dias, R. M. (2023). Editorial: Exercise intervention for prevention and management of hypertension. Frontiers in Physiology, 14, 1244715. https://doi.org/10.3389/fphys.2023.1244715

Hart, E. C., & Charkoudian, N. (2017). The Complex Challenge of Blood Pressure Regulation. In Principles of Gender-Specific Medicine (pp. 611–620). Elsevier. https://doi.org/10.1016/B978-0-12-803506-1.00032-2

Henkin, J. S., Pinto, R. S., Machado, C. L. F., & Wilhelm, E. N. (2023). Chronic effect of resistance training on blood pressure in older adults with prehypertension and hypertension: A systematic review and meta-analysis. Experimental Gerontology, 177, 112193. https://doi.org/10.1016/j.exger.2023.112193

Herlina, D. (2023). The Effect of Hypertension Exercise on Blood Pressure Control in the Elderly with Hypertension in the Working Area of Kumun Health Center. MAHESA : Malahayati Health Student Journal, 3(6), 1726–1735. https://doi.org/10.33024/mahesa.v3i6.10437

High Blood Pressure (BP). (2023). In H. J. N. Bethell & D. Brodie, Exercise (pp. 56–60). CABI. https://doi.org/10.1079/9781800621855.0011

Igarashi, Y. (2022). Effects of Differences in Exercise Programs With Regular Resistance Training on Resting Blood Pressure in Hypertensive Adults: A Systematic Review and Meta-Analysis. Journal of Strength and Conditioning Research, Publish Ahead of Print. https://doi.org/10.1519/JSC.0000000000004236

John, A. T., Chowdhury, M., Islam, Md. R., Mir, I. A., Hasan, M. Z., Chong, C. Y., Humayra, S., & Higashi, Y. (2022). Effectiveness of High-Intensity Interval Training and Continuous Moderate-Intensity Training on Blood Pressure in Physically Inactive Pre-Hypertensive Young Adults. Journal of Cardiovascular Development and Disease, 9(8), 246. https://doi.org/10.3390/jcdd9080246

Kokubo, Y., Iwashima, Y., & Kamide, K. (2015). Hypertension: Introduction, Types, Causes, and Complications. In G. Jagadeesh, P. Balakumar, & K. Maung-U (Eds.), Pathophysiology and Pharmacotherapy of Cardiovascular Disease (pp. 635–653). Springer International Publishing. https://doi.org/10.1007/978-3-319-15961-4_30

Lee, E. J., Anselmo, M., & Keller‐Ross, M. L. (2023). Blood pressure regulation during exercise: Is age central to the problem? The Journal of Physiology, 601(14), 2755–2756. https://doi.org/10.1113/JP284901

Lee, S. H., & Chae, Y. R. (2020). Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis. Journal of Korean Academy of Nursing, 50(6), 740. https://doi.org/10.4040/jkan.20169

Li, L., Liu, X., Shen, F., Xu, N., Li, Y., Xu, K., Li, J., & Liu, Y. (2022). Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in patients with hypertension: A meta-analysis. Medicine, 101(50), e32246. https://doi.org/10.1097/MD.0000000000032246

Loucks, E. B., Schuman‐Olivier, Z., Saadeh, F. B., Scarpaci, M. M., Nardi, W. R., Proulx, J. A., Gutman, R., King, J., Britton, W. B., & Kronish, I. M. (2023). Effect of Adapted Mindfulness Training in Participants With Elevated Office Blood Pressure: The MB‐BP Study: A Randomized Clinical Trial. Journal of the American Heart Association, 12(11), e028712. https://doi.org/10.1161/JAHA.122.028712

Lu, Z., Song, Y., Chen, H., Li, S., Teo, E.-C., & Gu, Y. (2022). A Mixed Comparisons of Aerobic Training With Different Volumes and Intensities of Physical Exercise in Patients With Hypertension: A Systematic Review and Network Meta-Analysis. Frontiers in Cardiovascular Medicine, 8, 770975. https://doi.org/10.3389/fcvm.2021.770975

Maya, Á. T. D., Assunção, M. J., Brito, C. J., Vieira, E., Rosa, T. S., Pereira, F. B., De Toledo Nóbrega, O., De França, N. M., & Ferreira, A. P. (2018). High-intensity interval aerobic exercise induced a longer hypotensive effect when compared to continuous moderate. Sport Sciences for Health, 14(2), 379–385. https://doi.org/10.1007/s11332-018-0444-3

Munir, N. W., Asfar, A., Sakir, R., & Asnaniar, W. O. S. (2021). Chronic Disease Management Program Exercise On Blood Pressure In Hypertensive Patients. Jurnal Aisyah : Jurnal Ilmu Kesehatan, 6. https://doi.org/10.30604/jika.v6iS1.764

Parati, G., & Ochoa, J. E. (2018). Blood pressure measurement in hypertension: Definition and classification of blood pressure levels. In B. Williams (Ed.), ESC CardioMed (pp. 2389–2401). Oxford University Press. https://doi.org/10.1093/med/9780198784906.003.0564_update_001

Raven, P. B., Potts, J. T., & Swi, X. (1997). Baroreflex Regulation of Blood Pressure during Dynamic Exercise: Exercise and Sport Sciences Reviews, 25, 365???390. https://doi.org/10.1249/00003677-199700250-00015

Ribeiro, A. S., Nunes, J. P., Coronado, K. E., Andrade-Lima, A., Dos Santos, L., Aguiar, A. F., Schoenfeld, B. J., & Cyrino, E. S. (2021). Effect of Resistance Training Intensity on Blood Pressure in Older Women. Journal of Aging and Physical Activity, 29(2), 225–232. https://doi.org/10.1123/japa.2020-0049

Salmon, T., Hatherley, J., & Sankaranarayanan, R. (2022). Hypertension: A cardiovascular risk factor. In S. Nadar & G. Lip (Eds.), Hypertension (Oxford Cardiology Library) 3E (3rd ed., pp. 41–48). Oxford University PressOxford. https://doi.org/10.1093/med/9780198870678.003.0005

Sardeli, A. V., Griffith, G. J., Dos Santos, M. V. M. A., Ito, M. S. R., Nadruz, W., & Chacon-Mikahil, M. P. T. (2020). Do baseline blood pressure and type of exercise influence level of reduction induced by training in hypertensive older adults? A meta-analysis of controlled trials. Experimental Gerontology, 140, 111052. https://doi.org/10.1016/j.exger.2020.111052

Schneider, V. M., Domingues, L. B., Umpierre, D., Tanaka, H., & Ferrari, R. (2023). Exercise characteristics and blood pressure reduction after combined aerobic and resistance training: A systematic review with meta-analysis and meta-regression. Journal of Hypertension, 41(7), 1068–1076. https://doi.org/10.1097/HJH.0000000000003455

Segar, J. L. (2013). Neurohumoral and Autonomic Regulation of Blood Pressure. In J. T. Flynn, J. R. Ingelfinger, & R. J. Portman (Eds.), Pediatric Hypertension (pp. 3–23). Humana Press. https://doi.org/10.1007/978-1-62703-490-6_1

Shariful Islam, M., Fardousi, A., Sizear, M. I., Rabbani, Md. G., Islam, R., & Saif-Ur-Rahman, K. M. (2023). Effect of leisure-time physical activity on blood pressure in people with hypertension: A systematic review and meta-analysis. Scientific Reports, 13(1), 10639. https://doi.org/10.1038/s41598-023-37149-2

Simamane, M., Constantinou, D., Gradidge, P. J.-L., & Watson, E. (2023). Physical Activity Interventions for The Management of Hypertension: A Scoping Review [Preprint]. In Review. https://doi.org/10.21203/rs.3.rs-2835337/v1

Smolensky, M. H., Hermida, R. C., & Portaluppi, F. (2017). Circadian mechanisms of 24-hour blood pressure regulation and patterning. Sleep Medicine Reviews, 33, 4–16. https://doi.org/10.1016/j.smrv.2016.02.003

Songcharern, N., Ruangthai, R., Tumnark, P., & Phoemsapthawee, J. (2022). Improved arterial stiffness after combined aerobic and resistance training: Correlation with heart rate variability change in prehypertensive offspring of hypertensive parents. Journal of Exercise Rehabilitation, 18(6), 395–405. https://doi.org/10.12965/jer.2244416.208

Stefani, L., Mascherini, G., Tosi, B., & Galanti, G. (2019). Hypertension Today: Role of Sports and Exercise Medicine. Journal Of Hypertension And Cardiology, 2(4), 20–27. https://doi.org/10.14302/issn.2329-9487.jhc-19-2714

Sutomo, S., Purwanto, N. H., & Siswantoro, E. (2023). APPLICATION OF MIND BODY THERAPY IN HYPERTENSION PATIENTS: LITERATURE REVIEW. Proceeding of International Conference of Kerta Cendekia, 2(1), 164–173. https://doi.org/10.36720/ickc.v2i1.518

Tamayo Acosta, J., Sosa Gomez, A. E., Samuel, S., Pelenyi, S., Acosta, R. E., & Acosta, M. (2022). Effects of Aerobic Exercise Versus High-Intensity Interval Training on V̇O2max and Blood Pressure. Cureus. https://doi.org/10.7759/cureus.30322

Trihartuty, T., Lestari, P., & Ulfiana, E. (2022). Aerobics Low Impact terhadap Tekanan Darah pada Penderita Hipertensi. Journal of Telenursing (JOTING), 4(2), 477–487. https://doi.org/10.31539/joting.v4i2.2668

Vieira-Souza, L. M., Aidar, F. J., Mota, M. G., Reis, G. C., Lima Júnior, C. M. A., Silva, F. J. A. D., Jesus, J. B. D., Azevedo, D. E. R. D., Marçal, A. C., & Santos, J. L. D. (2023). HIGH-INTENSITY INTERVAL TRAINING POSES NO RISK TO HYPERTENSIVE WOMEN. Revista Brasileira de Medicina Do Esporte, 29, e2021_0321. https://doi.org/10.1590/1517-8692202329012021_0321

Wehrmann, A., Tian, E. J., Tyack, E. (Liz), & Kumar, S. (2023). The evidence of effectiveness of isometric resistance training on the management of hypertension in adults: An umbrella review. Blood Pressure Monitoring, 28(4), 171–184. https://doi.org/10.1097/MBP.0000000000000655

Xi, H., He, Y., Niu, Y., Sui, X., Zhang, J., Zhu, R., Xu, H., Zhang, S., Li, Y., Yuan, Y., & Guo, L. (2021). Effect of combined aerobic and resistance exercise on blood pressure in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials. Experimental Gerontology, 155, 111560. https://doi.org/10.1016/j.exger.2021.111560

Published

09-01-2024

How to Cite

Abderrahmen, T., Chaouki, H. A., Mehamed, G., Khaled, K. A., & Rachid, B. (2024). Impact of exercise modalities on blood pressure control in hypertensive patients: A narrative review. International Journal of Health Sciences, 8(S1), 47–62. https://doi.org/10.53730/ijhs.v8nS1.14701

Issue

Section

Peer Review Articles