• Keeping blood pressure in a healthy range helps improve cardiovascular health and lowers the risk of death from certain causes, such as heart attack.

• A recent study found that increasing exercise-type activity, such as running or cycling, by as little as five minutes a day can help lower systolic and diastolic blood pressure.

• The results further support that longer bouts of exercise-like activity could lead to clinically significant decreases in blood pressure.

High blood pressure remains a common problem in the United States, affecting almost half the adult population. It contributes to death and increases the risk of serious problems such as heart disease and stroke. Experts are interested in finding the most research-supported methods to help lower high blood pressure.

A study published in Circulation looked at the effects of different activities on blood pressure.

The researchers found that increasing exercise-type activities, such as running, cycling and stair climbing, was associated with lower blood pressure. For example, findings suggest that interrupting 21 minutes of sedentary activity with exercise-like activity could lower systolic blood pressure by about 2 mmHg.

The results highlight how much exercise can influence blood pressure and that daily changes can greatly influence cardiovascular health.

How does physical activity affect blood pressure?

The researchers of the current study wanted to examine activity patterns over a 24-hour period and how they influence blood pressure, both systolic and diastolic readings. The researchers divided the activity into six distinct categories:

1. Sleep

2. Sedentary behavior

3. Permanent

4. Walk slowly

5. Walk fast

6. Exercise-like activities such as cycling and running

The cross-sectional study involved data from 14,761 participants from six observational cohort studies. These studies involved participants wearing motion trackers to see activity levels. People were eligible for analysis if they met certain criteria, such as wearing a movement tracker for twenty hours or more daily and having data from at least one weekday and one weekend day.

Participants spent an average of 16 minutes per day engaged in exercise-like activities and an average of over 10 hours per day engaged in sedentary behavior. Almost a quarter of the participants were taking medication for high blood pressure, and the average blood pressure was around 132/79 mmHg.

All cohorts accounted for some covariates such as alcohol consumption, smoking status, and age. Some cohorts collected data on additional covariates such as mobility and education level.

The researchers were able to perform several analyzes to examine the available data. They found that doing more exercise-like activities and sleeping were associated with lower systolic and diastolic blood pressure. Conversely, higher systolic and diastolic blood pressure was associated with higher levels of sedentary behavior.

Reducing sedentary time can improve blood pressure

When looking at activity reallocation, researchers found that replacing any other activity with exercise-like activities saw the greatest blood pressure benefit. For example, the researchers found that replacing five minutes of any other behavior with exercise-like activity was associated with about a 0.68-point drop in systolic blood pressure and about a 0.54-point reduction in diastolic blood pressure.

The results also suggest that more exercise might produce more significant reductions.

For example, the researchers estimated that about a two-point drop in systolic blood pressure was associated with replacing 21 minutes of sedentary activity with exercise-like activity, while leaving other activities the same. The researchers also estimated that a one-point drop in diastolic blood pressure was associated with replacing 11 minutes of sedentary time with eleven minutes of exercise-like activity.

The findings suggested that replacing sedentary activity with other activities such as walking could also help diastolic blood pressure, but that the reallocation of time needed to be greater. For example, replacing 95 minutes of sedentary behavior with 95 minutes of slow walking could help lower diastolic blood pressure by one point.

In sensitivity analyses, the researchers found some data that higher amounts of brisk walking might actually worsen diastolic blood pressure.

Following a review of the press release, non-study author Cheng-Han ChenMD, board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, noted the following about the study results: Today’s medical news:

What are the limitations of the study?

The research has some limitations, notably a lack of diversity despite including many participants. Second, the nature of the study did not allow for long-term data collection, which may be useful to explore in further research.

The study cannot establish causal associations. Researchers have acknowledged the possibility of misclassification, overlap, or undetected data on behavioral measurement. They also acknowledged that they did not directly measure activity intensity and were unable to examine sleep quality or how bouts of exercise affected the associations. Instead, they could only examine the average amount of time participants engaged in exercise each day.

Some of the cohort data was based on participant reporting, and some components, such as how blood pressure data were collected, varied between cohorts.

Additionally, a subgroup analysis looking at log isometric ratio observed no “interaction between sedentary behavior or exercise levels with SBP (systolic blood pressure).” This and other subgroup analyzes should be considered when interpreting study findings, such as those related to sleep and blood pressure.

More research may be needed to understand how changes in activities such as sleep and walking can affect blood pressure.

Can lifestyle changes help manage high blood pressure?

The researchers of this study advocate for strategies to allow people to incorporate more exercise into their daily lives. This could help create significant changes in blood pressure. Author of the study Joanna M. BlodgettPhD, noted the following in a recent press release:

In addition, other actions can help control blood pressure, such as reaching a healthy weight, limiting alcohol consumption, not smoking, and managing stress levels. During lifestyle changes to improve blood pressure, people should communicate regularly with doctors and specialists if necessary.

As Chen also noted, “The best forms of exercise for lowering blood pressure are those that involve aerobic activities, such as walking/jogging, cycling, and swimming/water aerobics. It’s also helpful to incorporate strength training, as this also helps improve blood vessel function and blood pressure… People with high blood pressure should talk to their doctor about lifestyle factors that can help to control blood pressure. In general, we recommend that people eat a healthy, balanced, low-sodium diet, engage in regular physical activity, get adequate quality sleep, maintain a healthy weight, avoid tobacco and alcohol, and reduce sources of stress .”

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