By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.

Although the general benefits of regular exercise are well established, it has not been clearly shown that people who have hypertension get the same protection from heart disease as others. A Swedish survey of 642 men, all aged 55, was begun in 1970 and then they were followed for the next 25 years. They were asked about their lifestyles at the start of the study, including their exercise habits. They were divided into two groups: 'non-vigorous' exercise (men whose most vigorous activity was something like walking to work), and 'vigorous' exercise (men who did things like running, swimming, or playing tennis for at least four hours a week). About one third (173) of the men were hypertensive, and those of them who reported vigorous exercise had one third the risk of dying from heart disease compared with the more sedentary men over the following 25 years. And their death rate from any cause was cut by more than half. The benefits of exercise were greater in the men with hypertension than in the others who had normal blood pressure.

Doctor’s comments

Many people with hypertension are worried that exercise may be dangerous, because it raises the blood pressure (although the pressure is low for several hours afterwards). If the pressure is really high, exercise is not recommended until it is under control, but it doesn’t have to be normal. In the hypertensive men who exercised vigorously in this study, the average pressure was 157/97 mm Hg. One of the most interesting findings was that vigorous exercise appeared to be more beneficial in the hypertensive men than in the others.

Where it was published