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Jul 06 2016

Paper: Hypertension – Exercise and Diet as a Medicine

Hypertension          In this article, I will discuss the complex intricacies of hypertension and how physical exercise should be the best recommended and easiest way to start to reduce high blood pressure in individuals with the condition.  A couple weeks ago during office talk, the subject of hypertension was brought up.  I am used to talking fitness and health and nutrition where colleagues usually joke about my extreme fitness and “crazy” adventures or abilities to run 50 miles on a weekend day and coworkers always have questions about nutrition, fueling, diets, and weight loss. I have a standard response about how everything is tied back to nutrition and to try and take out the carbs, sugar and processed foods, eat high amounts of fruits, vegetables, high fats like eggs, avocados etc. My audience of co-workers tend to ask questions about diabetes, pre-diabetes, weight loss or obesity issues, but when the colleague mentioned hypertension and how it was completely separate from diabetes related issues, I thought hard about if this was the case.  My initial gut reaction was that most conditions westerners face from heart disease, diabetes, obesity, and to a certain extent forms of cancer, can originate with nutritional problems in our diet followed by physical inactivity.  I am probably an extremely outlier, but the more I study in literature, textbooks, studies, and fitness, the more I see that nutrition plus exercise can in the majority of cases solve most conditions that we read about in this chronic disease chapter.

            Whether or not hypertension contained independent causes for the condition than causes for diabetes had me researching more about hypertension. We have learned from our reading that hypertension is high blood pressure above 140/90 mm HG (Powers and Howley, 2012, p. 196), and its cause is multifactorial and complex. According to Powers and Howley (2012, p. 322), metabolic abnormalities like obesity, insulin resistance, and dyslipidemia (lipid abnormalities) plus smoking can cause high blood pressure.  However, those metabolic abnormalities can be traced back to poor nutrition over time, and lack of physical exercise which compounded lead to obesity, insulin resistance and hypertension. With 68 million Americans having hypertension, it is in the best interest of these individuals and the health care system as a whole to minimize this condition, especially if it can be avoided.  Multiple sources point to both diet and exercise as the easiest non-pharmacological way to reduce hypertension.  Going back to my original thought that like diabetes, hypertension can be controlled through diet and exercise, I believe it can.

            The article I chose in this writing was a piece in a Canadian Research Press entitled: Exercise as medicine: Role in the management of primary hypertension (Millar and Goodman, 2014). The authors state that 20% of the Canadian population is affected by hypertension, which contributes to cardiovascular disease and ultimately increased mortality. They show that hypertension itself can be prevented or at least reduced through a combination of exercise with better diet choices and decreased lifestyle risks such as smoking and alcohol consumption.  Instead of focusing on drugs as a solution to reducing blood pressure, Millar and Goodman point out that lifestyle modifications first and foremost like exercise should be considered as the solutions. They point out that multiple studies show all sorts of exercise from aerobic to weight resistance training and even high intensity training does appear to reduce blood pressure.   While initial results might seem minimal, my own personal learning through experience and from the text in Applied Physiology (Powers and Howley, 2012, p. 323) results can be compounded after exercise coupled with nutritional eating and continued positive lifestyle choices.  A cycle begins to emerge: exercise lightly, eat nutritionally, body adapts to changes, blood pressure reduced a little, ability to exercise more, desire to eat more nutritionally, future positive body changes in heart, lungs, muscles, more loss of weight, and a continual positive cycle eventually reduces or almost eliminates the risk for cardiovascular disease from hypertension or other conditions. 

            Powers and Howley in Applied Physiology and Millar and Goodman in their Exercise as Medicine piece both point to the role of exercise to lower blood pressure and hypertension. Both first recommend screening programs by a physician, but both point out the power of exercise over pharmacological solutions as a simple way to reduce blood pressure (Powers and Howley, 2012, p. 380). Using exercise as medicine ends up not only saving money or possible negative side effects from drugs, but exercise with nutrition will usually lead to overall healthy lifestyle and a reduced risk of other chronic disease diagnoses.  Exercising at a moderate intensity 40-60% VO2 Max for 30 minutes a day for up to seven days a week can have profound results on overall reduction of blood pressure (Powers and Howley, 2012, p. 380).

            Going back to my discussion with my co-worker about hypertension and if my initial thoughts that eating nutritiously with combined with a little exercise can help hypertension just like diabetes related issues I think can be taken positively.  While it is true persons should take prescribed medication and reduce salt intake for hypertension, those do not get at the root of the problem, which is overall lifestyle choices can be modified to reduce not only blood pressure but weight loss and overall health condition.  Starting with exercising each day plus eating non-processed foods will start the positive cycle of overall healthier living.

References:

Millar, P. J., & Goodman, J. M. (2014). Exercise as medicine: Role in the management of primary hypertension. Applied Physiology, Nutrition & Metabolism, 39(7), 856-858. doi:10.1139/apnm-2014-0006

Powers, S. K., & Howley, E. T. (2012). Exercise physiology: Theory and application to fitness and performance (8th ed.). New York, NY: McGraw Hill.

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