Exercise Reduces Cardiovascular Risk From Controlled Hypertension

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Exercise Reduces Cardiovascular Risk From Controlled Hypertension

As anyone who treats people with diabetes knows, blood glucose is just one of the areas where effective management is important. It’s also critical to keep track of — and manage — blood pressure, cholesterol and triglycerides, plus body weight and waist circumference.

Blood pressure is a key factor in your risk of experiencing a cardiovascular event, such as a heart attack or stroke — a risk that’s already higher if you have diabetes. So any steps you can take to lower the risk of a cardiovascular event based on having high blood pressure (hypertension) are worth knowing about.

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A new study contains some bad news, showing that even if you have your hypertension under control, you’re still at higher risk for cardiovascular events than a person without hypertension in the first place. But exercise can help reduce the higher risk associated with having controlled hypertension.

Under control, but still at higher risk

The study, published in the journal Heart, looked at over 3.8 million people ages 40 to 69 in Britain and South Korea who took part in long-term observational studies. Participants were excluded if they previously had a cardiovascular event like a heart attack or stroke, or if they had hypertension that wasn’t treated.

The researchers grouped participants into three categories: those without hypertension, those with controlled hypertension (defined as blood pressure below 140/90 mm Hg) and those with uncontrolled hypertension. They were interested at looking at differences between these groups in major cardiovascular events like heart attack or stroke, as well as in death from all causes.

The researchers found that compared with participants with normal blood pressure, those with controlled hypertension were significantly more likely to experience major cardiovascular events — 73% more likely in the British subset, and 46% more likely in the Korean subset. They were also more likely to die from all causes, with British participants 28% more likely and Korean participants 29% more likely to die if they had controlled hypertension, compared with not having hypertension.

These results can easily be seen as bad news, in the sense that even with their blood pressure brought under control, people with hypertension were more likely to experience a heart attack, a stroke or death. But the silver lining was that among those with controlled hypertension, there was a drastic difference in these risks based on whether or not they reported regular moderate-to-vigorous exercise. Those who reported no such exercise had a much higher risk of poor outcomes, similar or even higher than the risk level seen in participants with uncontrolled hypertension who reported getting exercise.

The main lesson from this study, according to the researchers, is that people with controlled hypertension shouldn’t assume they have the same lower risk of outcomes like heart attack, stroke or death as people without hypertension. Instead, they should take all steps possible — including lifestyle measures like exercise — to reduce their elevated risk of poor health outcomes.

Lessons for treating hypertension

The study also holds some lessons for doctors treating people with hypertension, according to a Healio expert commentary on the study by Michael A. Weber, MD, a cardiologist at the State University of New York Downstate Medical Center.

One lesson, according to Weber, is that treating hypertension — even effective treatment — won’t immediately fix structural abnormalities that led to the hypertension in the first place. So doctors should still be vigilant in screening people with treated hypertension for other issues that increase their risk for cardiovascular events, and in recommending lifestyle measures to reduce this risk.

Another lesson is that following the most recent guidelines for treating hypertension — with a goal of achieving blood pressure below 130/80 mm Hg for most patients — could have major benefits, since using this threshold for the study most likely would have greatly reduced the risk seen in participants with controlled hypertension, to a risk level closer to that of participants without hypertension.

Talk to your doctor if you have concerns that your blood pressure isn’t being managed aggressively enough, or if you’d like to incorporate more lifestyle measures like exercise into your blood pressure treatment plan.

Want to learn more about keeping your heart healthy with diabetes? Read “Tips for a Healthy Heart,” “Lower Your Risk of Heart Disease” and “Fight Off Heart Disease With These Five Heart-Healthy Foods.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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