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Exercise in the treatment and prevention of hypertension

Norman M Kaplan, MD
Section Editor
George L Bakris, MD
Deputy Editors
Daniel J Sullivan, MD, MPH
John P Forman, MD, MSc


Long-term aerobic exercise regimens (in most studies) have had a beneficial effect on the systemic blood pressure (BP) and therefore may reduce the incidence of hypertension [1-6]. During aerobic exercise, there is an appropriate elevation in BP, primarily systolic. However, some subjects have an exaggerated increase in BP during exercise, which may be an adverse prognostic sign. In addition to aerobic exercise, resistance training has been shown to reduce BP [7].


Both aerobic exercise and resistance training lower resting blood pressure (BP).

Aerobic exercise — Regular aerobic exercise can lower the BP by as much as 5 to 15 mmHg in patients with primary hypertension (formerly called "essential" hypertension), although the effect is not as pronounced among older individuals [8]. In meta-analyses of randomized, controlled trials, the mean reduction in systolic and diastolic BP was 4 to 6 and 3 mmHg, respectively [1,9,10]. Patients with resistant hypertension may also benefit from aerobic exercise [11].

Swimming training also can have a beneficial effect [12]. It may be particularly useful in patients with orthopedic problems or, because of the warm, humid environment, those with bronchospasm. (See "Exercise-induced bronchoconstriction".)

A similar fall in BP has been demonstrated in subjects with borderline hypertension, with the BP often being lowered into the normal range [13]. By comparison, the incidence of hypertension is increased in individuals with a low level of fitness [2,14].

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Literature review current through: Nov 2017. | This topic last updated: Jan 11, 2016.
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