Sport and hypertension

Edited by Dr. Gianfranco De Angelis

In this last period the studies on the relationship between hypertension and physical activity are innumerable. I will try to summarize them to give the reader the basic information.
The adaptations of the cardiovascular system consequent to motor activity are manifold, I will limit myself to highlighting those that are related to our problem: hypertension.

It has been seen that following physical activity there is a reduction in sympathetic tone and an increase in capillary density. Although these two effects show that physical activity is good for hypertensive people, it is not so simple, as during a demanding physical activity the pressure increases, endangering the hypertensive athlete. So, summing up, when you practice physical activity the pressure increases, instead in the long period of time (ie following a prolonged workout) the pressure decreases. These statements of mine may seem contradictory, but so far I have not talked about either the type of exercise or the degree of hypertension. We can classify the hypertensive in two groups: the "borderline" hypertensive, with blood pressure values ​​of 135-140 mmHg maximum and 85-95 mmHg minimum, and the real hypertensive, who have systolic above 140-160 mmHg and the diastolic above 90-95 mmHg. It has been seen that, following adequate physical activity, in "borderline" hypertensive patients there is a notable reduction in both maximum and minimum blood pressure values; in stable hypertensive patients, on the other hand, the researches are discordant, but according to several authors (Hanson, Bonanno, Comasink) even in stable hypertensive patients the pressure decreases.
Now let's see the recommended physical activity and the way to do the training without running risks. The hypertensive person is a sick person and as such needs special precautions: physical activity must be of aerobic and dynamic type; physical effort should be graduated in such a way as to cause an increase in heart rate up to values ​​equal to about 70% of the theoretical maximum; the training program should include at least three training sessions per week, lasting about 45 minutes each, which are sufficient to obtain a good pressure drop (Lewis and Comann of the "International Board of Medicine) . You have to start with a bit of free body gymnastics, then you choose the sport, which must be aerobic and dynamic; this is because isometric efforts increase the pressure too much, both systolic and diastolic. Examples of aerobic and dynamic sports are walking, running, swimming, cross-country skiing and cycling. There is no doubt that even in this case, as we are dealing with patients, close medical supervision is required.