This one is super important. Over the last ten years the number of people taking high blood pressure medications increased by 50%. We also know that despite pharmacologic 💊 (drug) advances only one third of adults with high blood pressure achieve adequate BP (blood pressure) control.
On the testing side there’s issues too. Access to 24 hour Holter monitors is challenging for both patients and doctors.
There are solutions.
Let me share with you the magic of exercise and how it can be used to treat blood pressure and unmask hidden hypertension.
Treating High Blood Pressure
In the few years I have been working as an exercise physiologist (EP) one of the most common reasons to come and see me is when someone is suffering with hypertension. Sometimes it has already been diagnosed and my client is taking appropriate blood pressure medications.
Often it hasn’t.
Part of our thorough history taking involves asking about your blood pressure… The most popular answer?
“My doctor says my blood pressure is fine“
This is a hard one for us EPs, particularly when looking at uncontrolled hypertension.
Is it actually fine?
Does this square with the literature?
What about masked (or hidden) high blood pressure?
As you know, elevated blood pressure is a risk factor for heart disease, heart failure, stroke and chronic kidney disease. There’s one stat that keeps glaring back at me:
“The proportion of adults with uncontrolled high blood pressure increased with age – from 10% or less among 18–34-year-olds to a peak of 47% at age 85 and over.”AIHW, 2019
Almost half of people over 85 with uncontrolled hypertension? Yikes.
Combine that with the statistics up the top of this article and we’ve got ourselves ticking health time bombs.
Blood Pressure & Exercise
From a short-term standpoint, we experience a nice response of exercise hypotension. This is where our blood pressure drops below ‘normal’ resting values after a bout of aerobic physical activity. This hypotension response can last hours post-exercise.
In the long term, regular exercise regimes alone have been shown to decrease resting blood pressure. Imagine what can be achieved with medication and exercise together. There is a truckload of evidence on this and there’s no surprise that people with a combination of the two receive fantastic results when it comes to reducing their blood pressure.
So as an exercise professional, I recommend regular aerobic exercise and physical activity along with other lifestyle modifications.
Diet, strategies to break up sedentary behaviours, and strategies that assist with behaviour change. Everyone is different and exercise prescription must be individualised relative to our own personal exercise capacity.
Blood Pressure Tests
Many of you will know that for a long time exercise has been included as a treatment strategy for hypertension but what about as a testing tool?
In 2016, interesting new research was put forward by a well-known Tasmanian researcher Dr. Martin Schultz. Schultz and his colleagues designed a short exercise test to unmask ‘masked’ clinical hypertension.
This was done through a modified Bruce protocol with regular blood pressure monitoring. The results of the study had a high sensitivity and correlation between the exercise test results and with 24hr Holter monitoring.
Their key finding was:
‘Blood pressure >150 mmHg during early stages of the exercise stress test is associated with presence of hypertension identified with 24hr Holter monitoring.’Schultz & Friends, 2016.
This is really cool and a promising finding. We can use exercise testing as useful tool and serve as a warning signal for the presence of hypertension.
You can come in and have a session with us in clinic where we can conduct the testing to see how your blood pressure is really going and unmask any hidden dangers.
What Role Can Exercise Physiologists Play?
Now I don’t like framing exercise as the silver bullet in relation to hypertension. I don’t want to come across as a crazy exercise nut. But I do think there’s value in phrases about exercises like this one.
‘If you could put the benefits of exercise in a pill, it would be the most prescribed drug in the world’Me (and many other EPs before me)
It really speaks to the global benefits of exercise across the vast range of chronic health conditions that affect us all.
Now when it comes to hypertension us EPs can be there to help you test and screen to see if you have it, or hidden high blood pressure. We can also be vital in your treatment too.
What are you waiting for? If you have high blood pressure you can book in with us online to get tested and treated today.