Can Exercise Match Drugs for Lowering Blood Pressure?

Among American adults, 29 percent have high blood pressure. Less than half of them have it under control. But more than three quarters of them take blood pressure meds. By contrast, only one quarter of American adults get the exercise that’s recommended for good health. However, a new study in the British Journal of Sports Medicine tells us that this is a huge missed opportunity.

With a large network meta-analysis, researchers found that exercise might be just as effective as drugs for lowering blood pressure in people with hypertension.

Analysis of 391 RCTs

This research looked at data from 391 randomized controlled trials. Among those studies, 197 evaluated exercise programs. Another 194 studies evaluated meds. Looking across all populations in all of the studies, the researchers did find that meds had a bigger effect on blood pressure than exercise did.

However, when they looked specifically at populations of people with hypertension, that difference disappeared. Meds and exercise were equally effective for lowering high blood pressure.

Missed Opportunities and Practical Considerations

In obesity, medication studies always compare the drugs plus diet and exercise to diet and exercise alone. Just to gain approval, an obesity med has to work better in combination with diet and exercise than diet and exercise alone. But in hypertension, the investigators could find no drug studies that used exercise for a comparator. None.

The practical dilemma is this. Primary care providers are pressed for time. Lifestyle interventions are not as simple as prescribing a pill. So we’re all missing opportunities for better health as a result.

Click here for the study and here for further perspective.

Bike on Dock, photograph © Grant MacDonald / flickr

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December 22, 2018