Bodily exercise Finest first-line for hypertension, ldl cholesterol

The best first step to tackling mild to moderately high blood pressure and cholesterol in otherwise healthy adults is a “recipe” to sit less and move more, according to a new scientific statement from the American Heart Association (AHA).

“The American Heart Association’s current guidelines for diagnosing high blood pressure and cholesterol recognize that otherwise healthy individuals with mildly or moderately elevated levels of these cardiovascular risk factors should actively seek to reduce these risks,” said Bethany Barone Gibbs, PhD, chairman of the statement Writing group said in an AHA press release.

“The first treatment strategy for many of these patients should be changing healthy lifestyles, beginning with increased physical activity,” said Gibbs of the University of Pittsburgh.

The AHA’s 12-page Scientific Statement – Physical Activity as a Critical Component of First-Line Treatment for High Blood Pressure or Cholesterol: Who, What, and How? – was posted online in Hypertension on June 2nd.

Every little bit helps

According to the AHA, approximately 21% of American adults have systolic blood pressure between 120 and 139 mm Hg or diastolic blood pressure between 80 and 89 mm Hg, which meets the criteria for lifestyle-only treatment for high blood pressure described in the American College Cardiology (ACC) / AHA guideline for high blood pressure.

In addition, about 28% of American adults have LDL cholesterol above 70 mg / dL and otherwise meet the criteria for low risk of heart disease or stroke. These individuals would meet the lifestyle-only treatment criteria outlined in the 2018 ACC / AHA Treatment Guidelines for Cholesterol, which include increased physical activity, weight loss, better diet, smoking cessation, and moderate alcohol consumption.

“Of the recommended lifestyle changes, increasing physical activity has extensive benefits, including improvements in blood pressure and blood cholesterol that are comparable, superior to, or complementary to other healthy lifestyle changes,” the group says.

“Physical activity assessment and prescription are an excellent lifestyle behavior treatment option for all patients, including the large population of mild to moderate risk patients with high blood pressure and cholesterol,” they note.

Research has shown that increasing physical activity can lead to clinically meaningful reductions in systolic and diastolic blood pressure of 3 or 4 mm Hg and a reduction in LDL cholesterol of 3 to 6 mg / dl, the authors emphasize.

Previous evidence also shows that physically active people have a 21% lower risk of cardiovascular disease and a 36% lower risk of death from cardiovascular disease than those who are inactive.

Physical activity also has benefits beyond heart health, including lower risk of some cancers; improved bone, brain, and mental health; and better sleep, they find out.

The U.S. Department of Health’s 2018 Physical Activity Guidelines recommend Americans do 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous aerobic activity each week and participate in two or more weekly strength training sessions.

However, there is no minimum period to receive physical activity benefits.

“Any little activity is better than none. Even small initial increases of 5 to 10 minutes a day can have health benefits,” Gibbs said.

Translational advice for clinicians

The AHA statement encourages clinicians to question patients about their physical activity with every interaction; Providing ideas and resources to help patients improve and maintain regular lifelong physical activity; and encourage and celebrate small increases in activity, such as B. more walking or climbing stairs to increase motivation.

“In our world where physical activity is increasingly banned from our lives and the overwhelming requirement is to sit – and even more so now that the nation and the world are practicing quarantine and isolation to reduce the spread of the coronavirus – the Message We Need It is more important than ever to ‘sit less and move more’ all day, to be adamant, “said Gibbs.

The statement was prepared by a volunteer writing group on behalf of the AHA Council on Lifestyle and Cardiometabolic Health; the Council on Cardiovascular and Stroke Care; and the Council on Clinical Cardiology.

This research had no commercial funding. A list of the disclosures for the writing group is available with the original article.

Hypertension. Published online June 2, 2021. Full text

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