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High Blood Pressure Reduced with Evening Aerobic Exercise

It’s estimated that worldwide one billion people have hypertension – high blood pressure – the force of your blood pushing against the walls of your blood vessels – being consistently too high.

The American Heart Association defines stage 1 hypertension, as a systolic pressure (top number) of 130-139, and a diastolic number (bottom) of 80-89 – with stage 2 reflecting 140 or higher over 90 or higher.

Over time, the force and friction of high blood pressure damages the delicate tissues inside the arteries, which then allows LDL (bad) cholesterol to form plaque along tiny tears in the artery walls – signifying the start of atherosclerosis.

Medications help to control at-risk BP. However, low physical activity is as much a risk factor for cardiovascular morbidity and mortality, as being viscerally (abdominal) overfat and a high sodium diet. The DASH Diet (dietary approach to stop hypertension) has proven successful helping to reduce the risk to high BP – advocating daily sodium intakes, in certain cases, not to exceed 1500 milligrams per day.

Research – “Morning Versus Evening Aerobic Training Effects on Blood Pressure in Treated Hypertension” – which appears in the March issue of Medicine & Science in Sports & Exercise – reports that, “a classic meta-analysis that included 26 randomized controlled trials with hypertensives concluded that aerobic training decreases systolic BP by 8 mm Hg and diastolic BP by 5mmHg, with the greater reductions obtained with training sessions conducted 2–3 times per week, lasting 30–45 min and with moderate intensity.”

Controlled exercise for the recommended frequency, intensity, time, and type has been shown to provide a post exercise hypotensive (low BP) effect, although research says, “BP reductions after aerobic training vary across studies.” Factors, such as higher initial BP, moderate to high training intensities, and associated diet-induced weight-loss, “have been identified as promoters of greater BP decrease.”

Twenty-five percent of individuals with elevated BP appear to be non-responders to exercise and do not demonstrate BP decreases, because of genetic characteristic and/or other unrecognized factors. Time of day in which aerobic exercise is employed can affect reductions in BP post exercise.

Researchers from the Universities of Sao Paulo and Oregon sought to compare the BP lowering effect of aerobic training performed in the morning versus evening in individual currently under treatment for elevated BP.

Fifty treated, hypertensive men – randomly allocated to three groups: morning training (MT), ET, and control (C) – cycled for 45 min at moderate intensity (progressing from the heart rate of the anaerobic threshold to 10% below the heart rate of the respiratory compensation point) The C group stretched for 30 min.

Training was performed three times per week for ten weeks – with clinic and ambulatory BP, hemodynamic, and autonomic mechanisms evaluated before (7 am to 9), and after the exercise sessions (6 pm to 8).

The main’s study outcome was that, in treated hypertensive men, “only aerobic training performed in the evening produced clinic and ambulatory hypotensive effects.”

The researchers went on to comment that, “aerobic training conducted at both morning and evening increased baroreflex sensitivity with a greater effect after ET (evening training).

James Tebbe, a Family Medicine physician at the Ochsner Health System Mid-City Clinic, and my personal physician, says, “often times, with today’s hectic lifestyles and ever-changing schedules, setting aside time to exercise can be difficult.  For some, I recommend placing it on your schedule like you would any appointment.”

Tebbe says the study, “shows a BP advantage to exercising in the evening. Yet, many folks choose to exercise in the early morning for practical reasons. Others exercise during the lunch hour, with some finding it easier exercise at the end of the day. The most important thing is to exercise, no matter what time of day it is.”

Just do it!

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