What’s Better For Your Hypertension:  Medication or Exercise? 

High blood pressure is probably the most common cardiovascular issue among adults; at least, in the developed world.  In fact, it is so common that even some of the most active—and healthy—people are diagnosed with hypertension. Or, at the very least, with higher-than-normal blood pressure.

As a matter of fact, blood pressure is a metric that health officials do not track as often as they probably should.  At least, that is what a new study seems to suggest. Data shows that approximately one-third of all Americans have high blood pressure and roughly another one-third have prehypertensive conditions.  But as prevalent as it appears to be, the data also warns that only about half of those who have blood pressure actually have it under control.

Fortunately, it looks like simply adding a regular exercise regimen can improve blood pressure for anybody, to the point that you may not even need medication.

In the new study, researchers took data from about 400 randomized trials which assessed the effects that blood pressure medicines and exercise on blood pressure.  These trials found that both of these intervention methods could lower blood pressure by as much as 9 mmHg (millimeters of mercury) in those patients who have hypertension.

London School of Economics and Political Science health policy researcher Huseyin Naci summarizes, “Exercise seems to achieve similar reductions in systolic blood pressure as commonly used antihypertensive drugs among people with high blood pressure.”

Along with colleagues, the lead study author observed 194 randomized controlled trials testing for anti-hypertensive medication efficacy in patients with either high blood pressure or elevated pressure and hypertension risk, as well as 197 trials testing the effect of exercise on hypertensive patients.

Normal blood pressure is measured as 120/80 mmHg (or below), according to the American Heart Association.  The AHA also considers a blood pressure to be “elevated” when the systolic pressure (the top number) is between 120 and 129 and the diastolic pressure (the bottom number) is less than 80.  However, in 2017, the AHA modified this rating to define hypertension stage 1 as a blood pressure higher than 130/80 and hypertension stage 2 as a blood pressure above 140/90.

Heart surgeon Larry Creswell, MD, simply concludes that exercise, generally, results in lower blood pressure. More specifically, he says, “Physically active people have a 50 percent lower risk for developing hypertension than inactive people, but some people will still develop it despite getting regular exercise.”