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Impact of Resistance Training on Blood Pressure

Posted in

Wednesday, Feb 10, 2021

Can Resistance Training Alone Help to Reduce Resting Blood Pressure in Hypertensive Adults?


The major emphasis within the current public health guidelines for physical activity is to accumulate a minimum of 150 minutes of moderate intensity aerobic activity each week. The health benefits of meeting this guideline are indisputable; just about everyone knows that regular aerobic exercise helps to reduce body fat and resting blood pressure, as well as improve blood cholesterol, glucose, insulin, and triglyceride values. These changes lead to a substantially reduced risk of chronic conditions such as cardiovascular disease, some cancers, and type 2 diabetes.       

Another message within the public health guidelines is a recommendation to perform resistance training at least twice a week. We all know that resistance training has many benefits; it helps to keep our bones strong and also keeps us functional as we age. Traditionally, aerobic exercise has been recommended as the most beneficial type of exercise to reduce resting blood pressure in hypertensive individuals. Countless studies have verified the effectiveness of aerobic training in this regard. On the other hand, relatively few well-controlled studies have examined the effectiveness of resistance training by itself for reducing resting blood pressure in the hypertensive population. 

In an issue of Hypertension Research, investigators summarized the results of 5 existing randomized controlled trials (RCT) by using a technique called a meta-analysis. In a RCT, subjects are randomly assigned to either a treatment group or a control group. In this case, the treatment groups were initially sedentary hypertensive individuals who then performed resistance training, while the control groups were sedentary hypertensive individuals who remained sedentary. Approximately 80% of the subjects were older than age 60, while the average duration of the resistance training program was 12 weeks. All 5 studies used a training frequency of 3 days per week. The total number of exercises used ranged from 7 to 15. The total number of sets per session ranged from 14 to 30, while the number of repetitions for each individual set ranged from 8 to 25. The combined results of the 5 studies are shown in Figure 1 below.


As seen in the Figure, the average reduction in systolic blood pressure among the resistance training groups in the 5 studies was 8.2 mmHg, while the average reduction in diastolic blood pressure was 4.1 mmHg. Both of these changes were statistically significant, which means that it is highly unlikely that the change was due to chance alone. There was no change in resting blood pressure of the control groups. The authors concluded that resistance training by itself is effective in reducing blood pressure among hypertensive individuals.

This study in no way discourages aerobic exercise training for improving resting blood pressure. Current public health guidelines strongly recommend both aerobic and resistive exercise training for maximal health benefits. The authors of this study simply wanted to examine the effect of resistance training by itself on resting blood pressure among individuals with elevated resting blood pressure.

As you know, hypertension is a very common risk factor for cardiovascular disease. Recommended lifestyle changes for this population include not only increasing physical activity, but also losing weight if overweight, quitting tobacco, reducing dietary sodium intake, and increasing dietary intake of unrefined plant-based foods and fatty fish. The DASH diet in particular has been shown to be very effective in helping to reduce resting blood pressure among hypertensive individuals.  

One very important safety note: For individuals with a resting blood pressure >180/110 mm Hg, the American College of Sports Medicine strongly recommends that resistance training should not be undertaken. These individuals should seek immediate medical attention.  

Reference

Correa de Sousa, E., Abrahin, O., Ferreira, A. L., Rodrigues, R. P., Alves, E. A., Vieira, R. P. (2017). Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis. Hypertension Research, 40:927-931.  doi:10. 1038/hr.2017.69