Guided walking in hypertensive subjects: a selective therapy

Purpose: To assess the effects of walking on the blood pressure of adult sedentary subjects with different degrees of hypertension. Methods: 529 subjects with systolic blood pressure above 120 mmHg were enrolled. Blood pressure, body weight, body mass index, waist circumference and walking speed were determined at enrolment and after 6 months. Walking sessions guided by exercise physiologists were organized. Results: The average weekly walking time during the 6 months study period was up to 300 min. Of the 296 subjects completing the project (182 women 59.6 ± 9.0 years, and 114 men, 65.4 ± 8.6 years) 27 had a baseline systolic blood pressure (SBP) [160 mmHg, 35 between 150–159, 70 between 140–149, 89 between 130–139 and 75 between 120–129 mmHg. To analyze specifically the effects of walking on the blood pressure of the 296 hypertensive subjects finishing the project, they were subdivided into five subgroups with baseline SBP:[160 mmHg, between 150–159, between 140–149, between 130–139 and between 120–129 mmHg. Highly significant reductions in SBP were documented in each subgroup with lowering of -21.3 mmHg in the subjects with baseline values [ 160, of - 11.8 in the group 150–159, of - 7.5 in the group 140–149, of - 5.3 in the group 130–139 and - 2.6 in the group 120–129 mmHg. Highly significant reductions were also documented for diastolic pressure, body weight, body mass index and waist circumference. These reductions were nearly identical within the various groups. Walking speed increased significantly and uniformly in all groups. The study shows that in hypertensive sedentary subjects, walking is followed by marked reductions of SBP. Its lowering is proportional to baseline values: the higher the baseline values, the greater the blood pressure reductions observed. Walking safely and effectively lowers the blood pressure of hypertensive subjects and should be included as standard adjunctive therapy for hypertension. References Pescatello LS, MacDonald HV, Lamberti L, Johnson BT (2015) Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep 17(11):87 Ettehad D, Emdin CA, Kiran A et al (2016) Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 387(10022):957–967 Redon J, Mourad JJ, Schmieder RE, Volpe M, Weiss TW (2016) Why in 2016 are patients with hypertension not 100% controlled? A call to action. J Hypertens 34(8):1480–1488 Whelton PK, Carey RM, Aronow WS et al (2017) Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension