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Resistance training and Hypertension : Improving Cardiovascular Health

by A. Manolova | 14 May 2019

health, science, hypertension, high blood pressure, resistance training, fitness, blood, pressure, workout

According to the World Health Organization (WHO), heart diseases cause an estimated 17 million deaths a year, almost a third of all deaths. High blood pressure is believed to be responsible for nearly half of these deaths, 13% of deaths worldwide, and more than 8 million deaths per year. The WHO estimates that by 2025, 1.56 billion people will have high blood pressure. Increasing blood pressure is a major risk factor for cardiovascular diseases (stroke and coronary artery disease, in particular). The blood pressure is quantified by two values, the systolic (maximum pressure in the systemic circulation when the blood is ejected by the heart) and diastolic (minimum pressure in the systemic circulation when the heart is "relaxed") pressures. For most adults, normal blood pressure is 100-130 / 60-80 mmHg. But when these values exceed at rest 140/90 mmHg daily, it's chronic hypertension. Many factors influence systolic and diastolic blood pressure, including blood volume, arterial wall compliance, and peripheral resistance. While some genetic factors and diseases can lead to hypertension, the main cause is often behavioral (diet, alcohol consumption, smoking, sedentary lifestyle, etc.).

In addition to medication, physical activity, and specifically cardiovascular endurance, is recommended for the prevention, treatment, and control of high blood pressure. It improves various cardiovascular functions (including endothelial function) that result in lowering blood pressure, as we explained in a previous article on HIIT and hypertension. Today, the WHO estimates that about 50% of women aged 65 to 75 suffer from hypertension. This high prevalence in this population is partly due to an alteration in the functioning of the autonomic nervous system (balance between the exciting sympathetic and the relaxing parasympathetic). In people with hypertension, the activity of the sympathetic nervous system is higher, and that of the parasympathetic is lower. And in women over the age of 60, this condition is often associated with higher systemic vascular resistance, that is, the blood encounters more resistance to flow into the body, which has the consequence of increasing blood pressure. In this case, can resistance training help to improve health ?

The Study

To answer this question, a team of Brazilian researchers investigated the effect of a short-term resistance training program on the cardiovascular health of women over 60 with chronic high blood pressure. For this, the researchers recruited 25 sedentary women (all following a drug treatment of one or two drugs against hypertension). The study lasted 13 weeks. Participants were divided into two groups, an experimental group (n = 13) and a control group (n = 12). The first week served as a period of familiarization with the resistance training exercises, the second and the thirteenth week evaluated the participants before and after, and the experimental training protocol took place from the 3rd to the 12th week. At the end of the study, the control group was able to take part in the experimental protocol.

The resistance training program lasted 10 weeks, with 2 supervised sessions per week during the first 5 weeks and 3 weekly supervised sessions during the last 5 weeks. Each session consisted of 9 exercises performed in the following order: Seated leg press, seated rowing machine, trunk flexion, leg curl, bench press, trunk extension, push press, standing calf extensions and lat pull down (Sci-Sport Note : why this strange order, based on what logic ?...). During the 10 weeks of the program, the number of sets went from 1 to 3 and the number of repetitions from 9-11 to 13-15 while gradually decreasing the rest between the sets of 120s to 60s.

Concerning the assessments, the researchers measured, at rest, mean arterial blood pressure, systemic vascular resistance (ratio of mean arterial pressure to blood flow in the forearm), heart rate, and cardiac autonomic function through the heart rate variability. In addition to this, the participants were subjected to 1RM tests in the bench press and the leg press. The 1RM tests also allowed to calibrate the RPE (Rate Perceived Exertion) scale used (here, OMNI-RES) to allow the intensity of the efforts during the training program to be between 5 and 7.

Results & Analyzes

The main results of this study show that in women with hypertension, a program of 10 weeks of resistance training reduces the activity of the sympathetic nervous system (and tends to increase that of the parasympathetic), resting heart rate (- 6.2 beats / min), systemic vascular resistance (-9.3 units) and mean blood arterial pressure (-4.2 mmHg). The program also increased the maximum strength of the upper and lower body.

Mean blood arterial pressure

Figure 1. Mean blood arterial pressure.

Systemic vascular resistance

Figure 2. Systemic vascular resistance.

Rest Heart Rate

Figure 3. Rest Heart Rate.

The average blood pressure reduction demonstrated in this study has a real clinical significance since the scientific data show that a decrease of 3 mmHg can reduce the risk of coronary heart disease by 5%, stroke by 8% and the risk of all causes combined by 4%.

In addition, the authors found a significant inverse correlation between changes in parasympathetic modulation and those in mean blood arterial pressure. This correlation indicates that the increase in parasympathetic activity is related to the decrease in mean arterial pressure in women with hypertension. However, statistically, this correlation is limited by the fact that the results did not demonstrate a significant effect of resistance training on parasympathetic activity.

Practical Applications

This study highlights the impact of short-term resistance training on hypertension in women over 60 years old. The results are encouraging and demonstrate a beneficial effect on the nervous system, cardiovascular function and strength of the upper and lower limbs after 10 weeks of training. When we know the impact of weight training on bone mineral density (read our article on bone mineral density in postmenopausal women), this training mode is really very interesting in many ways. It would be relevant for a future study to be able to compare the effect of resistance training, HIIT cardiovascular training, and a combination of these two on high blood pressure.

References

  1. Oliveira-Dantas FF, do Soccoro Brasileiro-Santos M, Thomas SG, Silva AS, Silva DC, Browne RAV, Farias-Junior LF, Costa EC and da Cruz Santos A. Short-Term Resistance Training Improves Cardiac Autonomic Modulation and Blood Pressure in Hypertensive Older Women : A Randomized Controlled Trial. J Strength Sports Cond Article in press, 2019.

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