Why is exercise beneficial despite causing temporary hypertension?

From the Guidelines

Exercise is beneficial despite causing temporary hypertension because it leads to long-term improvements in cardiovascular health and blood pressure control. Regular physical activity strengthens the heart muscle, allowing it to pump more efficiently with less effort, which ultimately lowers resting blood pressure over time 1. While blood pressure does increase during exercise as the body demands more oxygen, this acute response is normal and typically returns to baseline shortly after activity ends. Exercise also helps reduce arterial stiffness, improves endothelial function, promotes weight management, reduces stress hormones, and enhances insulin sensitivity—all factors that contribute to better blood pressure regulation.

Some key points to consider when recommending exercise for individuals with hypertension include:

• The type of exercise: aerobic exercise training has consistently been found to lower BP, although dynamic resistance training also reduces resting BP, but with a smaller effect 1
• The frequency and duration of exercise: adults with pre- to established hypertension should participate in at least 30 min/d of moderate-intensity aerobic exercise on most days of the week, totaling 150 min/wk or more 1
• The importance of gradual progression: people with existing hypertension should start gradually and consult healthcare providers before beginning new exercise regimens 1

Overall, the long-term cardiovascular benefits of regular physical activity far outweigh the temporary blood pressure elevation during exercise, and adults should aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity weekly, combined with muscle-strengthening exercises twice weekly.

From the Research

Benefits of Exercise Despite Temporary Hypertension

• Regular exercise is beneficial for overall health, despite causing temporary increases in blood pressure 2, 3, 4.
• Exercise has been shown to reduce the risk of cardiovascular disease, coronary heart disease, and stroke 2, 3.
• Physical activity can lower blood pressure, improve glucose tolerance, reduce obesity, and enhance fibrinolysis 3.

Effects of Exercise on Blood Pressure

• Regular exercise can lead to a decrease in blood pressure, with an overall 5 mmHg decrease in systolic blood pressure 2.
• Exercise can reduce ambulatory blood pressure in patients with hypertension, with significant reductions in systolic and diastolic blood pressure 5.
• Aerobic exercise, in particular, has been shown to provide significant benefits for blood pressure control 5.

Strategies for Managing Exaggerated Blood Pressure Response to Exercise

• Low-intensity exercise is recommended for individuals with an exaggerated blood pressure response to exercise, although its efficacy is uncertain 4.
• Yoga has been shown to have antihypertensive effects in a general patient population, with significant reductions in systolic and diastolic blood pressure 6.
• Individuals with an exaggerated blood pressure response to exercise may need to take precautions to prevent disease development, such as monitoring their blood pressure and adjusting their exercise routine accordingly 4.

Key Findings

• Regular exercise is essential for preventing cardiovascular disease and reducing blood pressure 2, 3, 5.
• Exercise can have varying effects on blood pressure, depending on the individual and the type of exercise 4, 6, 5.
• More research is needed to fully understand the effects of exercise on blood pressure and to develop effective strategies for managing exaggerated blood pressure responses to exercise 4.