Different types of structured exercise—from endurance to resistance activities—were as powerful as drugs for lowering blood pressure, and they became even more effective for people who had the highest levels, which was anything above 140 mm Hg systolic blood pressure, the marker for the start of hypertension.
Exercise targets systolic pressure, the first number which records the amount of pressure in the arteries when the heart is beating.
It's an important discovery because antihypertensive prescriptions have increased by 50 per cent in the past decade, and this is likely to escalate further as the threshold for hypertension has recently been lowered to 130 mm Hg systolic.
There haven't been any studies that have directly assessed the effectiveness of exercise against antihypertensives, so researchers from the London School of Economics and Political Science looked at 194 clinical trials on antihypertensives, and 197 separate studies that looked solely at structured exercise and its impact on high blood pressure, and compared the two.
All the structured exercise plans were as effective as drugs for lowering high blood pressure, and the evidence was especially "compelling" for exercise that combined endurance—such as walking, jogging or cycling—and dynamic resistance training, which includes strength training with dumb-bells or kettle bells, the researchers found.
But they warn against abandoning the antihypertensives for exercise just yet. For one thing, people are notoriously bad at sticking to exercise programmes or going to the gym, and they also need to be monitored and assessed, and there may not be the resource available to do that.