JS-CME-3: EXERCISE IN THE PREVENTION AND TREATMENT OF HYPERTENSION AND ASSOCIATED CARDIOVASCULAR RISK

Abstract

Arterial hypertension and associated cardiovascular (CV) disease remain a health care challenge. The global prevalence of hypertension is estimated to be in the range of 30–45 %. In Europe, about 25 % of heart attacks have been linked with hypertension. Lifestyle interventions are an essential and established part of hypertension management and provide a most effective means to achieve recommended blood pressure targets. For example, patients with hypertension engaged in regular physical activity have been shown to have a reduced risk for CV mortality (20–60%), as opposed to sedentary patients with a twofold increased CV mortality risk. Independent of the severity of hypertension, lifestyle advice is a first line treatment modality for lowering blood pressure in all of the recent guidelines on management of hypertension. In 2021, the EAPC and ESC Council of Hypertension Consensus Document found consistent evidence from a meta-review that exercise prescription can be refined by recommending type of exercise treatment according to initial blood pressure levels as a more personalized lifestyle intervention. Moreover, the focus on recommendations for the treatment of hypertension may need to shift towards focusing on reduction of overall CV risk. Whereas anti-hypertensive drug treatment primarily lowers blood pressure, exercise treatment, for example, has the potential to beneficially affect most of the associated CV risk factors and thus very effectively reduce overall CV risk as well as prolong health span. Cumulative overall CV risk can be quantified by non-invasive assessment of micro- and macrovascular function. The susceptibility of vascular biomarkers in response to exercise treatment is vital to investigate the effects of exercise interventions on overall CV risk in patients with hypertension.