Exercise could be as effective as prescribed medication for reducing high blood pressure, according to new research.
A review of almost 400 clinical studies has for the first time directly compared trials of exercise and blood pressure-lowering drugs, to assess how both affected those with high blood pressure.
While none of the participants in the study had diabetes, the findings are relevant because diabetes is linked with increased risk of high blood pressure, as well as heart attack and stroke.
Researchers from London School of Economics and Political Science analysed 194 clinical trials which investigated the effect of medications in lowering systolic blood pressure and a further 197 studies examining the impact of structured exercise. Overall, the trials involved 39,742 people.
Three sets of analyses were completed, with structured exercises compared with every class of blood pressure-lowering drug, including varying exercise intensities and drug doses.
The findings suggested blood pressure was lower overall in people on medication than people on structured exercise programmes. However, when the researchers focused the analysis on people who had been diagnosed with high blood pressure, the results indicated that physical activity was as effective as tablets.
An advantage of lifestyle changes, such as exercise, is that it has additional benefits without the side effects that medication can bring.
Specifically, “combining endurance and dynamic resistance training” was shown to be particularly effective in reducing systolic blood pressure.
The researchers acknowledged, however, that the studies involving exercise were fewer and smaller than the drug trials.
Dr Huseyin Naci was the lead researcher and in a podcast released to mark the publication of the research, said: “We don’t think, on the basis of our study, that patients should stop taking their antihypertensive medications. But we hope that our findings will inform evidence-based discussions between clinicians and their patients.”
Dr Naci said prescribing exercise to people with high blood pressure was not straightforward.
“It’s one thing to recommend that physicians start prescribing exercise to their patients, but we also need to be cognisant of the resource implications and ensure that the patients that have been referred to exercise interventions can adhere to them and so really derive benefit,” he said.
The study was published by the British Journal of Sports Medicine.
Editor’s note: Prescriptions for blood pressure-lowering medications have doubled in England in the ten years up to 2016. This trend is set to continue with the high systolic blood pressure threshold lowering to 130 mmHg in recent clinical guidelines.
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