Hipertensión y Actividad

Física

Javier Ortega López

 Definición
La hipertensión, también conocida como tensión arterial alta o elevada, es un
trastorno en el que los vasos sanguíneos tienen una tensión persistentemente alta,
lo que puede dañarlos. Cada vez que el corazón late, bombea sangre a los vasos,
que llevan la sangre a todas las partes del cuerpo. La tensión arterial es la fuerza
que ejerce la sangre contra las paredes de los vasos (arterias) al ser bombeada por el
corazón. Cuanto más alta es la tensión, más esfuerzo tiene que realizar el corazón
para bombear.
La mayoría de las personas con hipertensión no muestra ningún síntoma. En
ocasiones, la hipertensión causa síntomas como dolor de cabeza, dificultad
respiratoria, vértigos, dolor torácico, palpitaciones del corazón y hemorragias
nasales, pero no siempre.
Si no se controla, la hipertensión puede provocar un infarto de miocardio, un
ensanchamiento del corazón y, a la larga, una insuficiencia cardiaca.

https://www.who.int/topics/hypertension/es/
 Definición
•  having a resting systolic BP (top number) of 130 mmHg or greater
•  having a resting diastolic BP (bottom number) of 80 mmHg or greater
•  taking antihypertensive medication
•  being told by a physician or health professional on at least two
occasions that one has high BP
•  or any combination of these criteria

The American College of Cardiology/American Heart Association

Task Force on Clinical Practice Guidelines
Exercise for the Prevention
and Treatment of
Hypertension

Regular aerobic exercise results in reductions in blood pressure of 5-7

mmHg among individuals with hypertension and these reductions
translate to a reduced risk of CVD of 20-30%.
Exercise for the Prevention
and Treatment of
Hypertension

Emerging research suggests that dynamic resistance exercise may also

serve as an efficacious strategy to lower blood pressure to levels similar to
aerobic exercise.
Exercise for the Prevention
and Treatment of
Hypertension

Emerging research suggests that dynamic resistance exercise may also

serve as an efficacious strategy to lower blood pressure to levels similar to
aerobic exercise.
Exercise for the Prevention
and Treatment of
Hypertension

Special consideration should be given to signs/symptoms or presence of

disease, concomitant drug therapy, and other comorbidities in order to
optimize CVD risk reduction and improve overall health. The goal of
preparticipation screening should be to risk classify individuals at risk for
an adverse or life threatening response to exercise while decreasing
barriers to physical activity participation.

Amanda Zaleski | Feb 27, 2019

http://www.acsm.org/all-blog-posts/certification-blog/acsm-certified-blog/
2019/02/27/exercise-hypertension-prevention-treatment
 Exercise Prescription
(Frequency)

The ACSM recommends that individuals with hypertension

engage in moderate intensity, aerobic exercise 5-7 d/wk,
supplemented by resistance exercise 2-3 d/wk and flexibility
exercise ≥2-3 d/wk.
 Exercise Prescription
(Frequency)
The frequency of aerobic exercise is slightly greater than
those with normal BP (i.e., 3-5 d/wk). In fact, individuals
with hypertension are encouraged to engage in greater
frequencies of aerobic exercise than those with normal BP
because we know that a single bout of aerobic exercise
results in immediate reductions in BP of 5-7 mmHg, that
persist for up to 24 hr (i.e., postexercise hypotension). For
this reason, individuals with hypertension are encouraged to
exercise on most days of the week in order to benefit from
the acute effects of aerobic exercise on BP.
 Exercise Prescription
(Intensity)

Moderate [i.e., 40-<60% VO2R or 11-14 on a scale of 6 (no

exertion) to 20 (maximal exertion) level of physical exertion
or an intensity that causes noticeable increases in heart rate
and breathing] for aerobic exercise; moderate to vigorous
(60-80% 1RM) for resistance; and stretch to the point of
feeling tightness or slight discomfort for flexibility.

Amanda Zaleski | Feb 27, 2019

http://www.acsm.org/all-blog-posts/certification-blog/acsm-certified-blog/
2019/02/27/exercise-hypertension-prevention-treatment
 Exercise Prescription
(Intensity)

https://cmsfitnesscourses.scdn6.secure.raxcdn.com/wp-content/
uploads/2018/12/cms-fitness-courses-rpe.jpg
 Exercise Prescription
(Intensity)

New and emerging evidence suggest that the magnitude of

the BP reductions that result from aerobic exercise occur as a
direct function of intensity, such that the more vigorous the
intensity, the greater the resultant BP reductions (PMID:
26423529). Individuals who are willing and able may
consider progressing to more vigorous intensities, however,
the risk-to-benefit ratio has not yet been established.
 Exercise Prescription
(Time)

For aerobic exercise, a minimum of 30 min or up to 60 min/

d for continuous or accumulated aerobic exercise. If
intermittent, begin with a minimum of 10 min bouts.
 Exercise Prescription
(Time)

New and emerging research has shown that short bouts of

exercise (3-10 min) interspersed throughout the day may
elicit BP reductions similar in magnitude to one continuous
bout of exercise and may be a viable antihypertensive
lifestyle strategy for individuals with limited time.
 Exercise Prescription
(Time)

Blood pressure reductions appear to occur in a dose-response

manner such that greater volumes of exercise elicit greater
reductions in blood pressure. Progression to the Ex Rx
should be gradual, avoiding large increases in any of the
FITT components of the Ex Rx, especially intensity for most
individuals with hypertension.
 Exercise Prescription
(Type)

For aerobic exercise, emphasis should be placed on

prolonged, rhythmic activities using large muscle groups
such as walking, cycling, or swimming.
 Exercise Prescription
(Type)

Resistance training may supplement aerobic training and

should consist of 2-4 sets of 8-12 repetitions for each of the
major muscle groups.
 Exercise Prescription
(Type)

On average, regular aerobic exercise lowers resting systolic

BP 5-7 mmHg, while resistance exercise lowers resting
systolic BP 2-3 mmHg among individuals with hypertension.
These BP reductions follow the “law of initial values” such
that individuals with higher baseline BP values experience
even greater reductions in BP from exercise training. In other
words, exercise works best in those who can stand to benefit
the most.
 Exercise Prescription
(Type)
A recent meta-analysis demonstrated dynamic resistance
exercise training to result in BP reductions similar in
magnitude to aerobic exercise training (PMID: 27680663).
These results suggest that the antihypertensive benefits of
resistance exercise training may have been largely
underestimated and warrant reappraisal in the near future.
Note that, inhaling and breath-holding while engaging in the
actual lifting of a weight (i.e., Valsalva maneuver) can result
in extremely high BP responses, dizziness, and even fainting
and should be avoided during resistance training.

Amanda Zaleski | Feb 27, 2019

http://www.acsm.org/all-blog-posts/certification-blog/acsm-certified-blog/
2019/02/27/exercise-hypertension-prevention-treatment