Cochrane for Clinicians

Putting Evidence into Practice

Can Walking Lower Blood Pressure in Patients With Hypertension?

 

Am Fam Physician. 2022 Jan ;105(1):22-23.

Author disclosure: No relevant financial relationships.

Clinical Question

Is routine walking an effective way to lower blood pressure?

Evidence-Based Answer

Walking lowers systolic blood pressure by 4.11 mm Hg (95% CI, 3.01 to 5.22 mm Hg). It lowers diastolic blood pressure by 1.79 mm Hg (95% CI, 1.07 to 2.51 mm Hg) and resting heart rate by 2.76 beats per minute (bpm; 95% CI, 0.95 to 4.57 bpm).1 (Strength of Recommendation: C, based on low- to moderate-certainty disease-oriented evidence.)

Practice Pointers

Hypertension can contribute to heart disease2 and is affected by an individual's physical activity level and lifestyle habits.3 Walking can be a relatively easy and affordable way to incorporate lifestyle changes and potentially lower blood pressure.

The authors of this Cochrane review evaluated studies of walking compared with no physical activity to lower blood pressure.1 This review included 73 randomized controlled trials and 5,763 participants. Participants were 16 to 84 years of age and normotensive or hypertensive men and women with various health conditions—the category “prehypertensive” was not discussed. The primary outcome was change in systolic blood pressure; secondary outcomes included changes in diastolic blood pressure and heart rate.

Walking as an intervention occurred in multiple environments, including at the participant's home, in the local community, or in a laboratory with a treadmill. Participants walked an average of 153 minutes per week for an average of 15 weeks. Although the intensity of activity was described as “moderate,” it varied among groups and was determined in a variety of ways, from heart rate or VO2 max (maximal oxygen consumption during intense exercise) to the speed of walking; in several studies walking intensity was not described at all.

The primary evaluation found moderate-certainty evidence that walking lowered systolic blood pressure (mean difference [MD] = 4.1 mm Hg; 95% CI, 3.0 to 5.2 mm Hg). Secondary evaluation found low-certainty evidence that walking lowered d

Author disclosure: No relevant financial relationships.

References

show all references

1. Lee L-L, Mulvaney CA, Wong YKY, et al. Walking for hypertension. Cochrane Database Syst Rev. 2021;(2):CD008823....

2. Amici A, Cicconetti P, Sagrafoli C, et al. Exaggerated morning blood pressure surge and cardiovascular events. A 5-year longitudinal study in normotensive and well-controlled hypertensive elderly. Arch Gerontol Geriatr. 2009;49(2):e105–e109.

3. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8) [published correction appears in JAMA. 2014; 311(17): 1809]. JAMA. 2014;311(5):507–520.

4. National Institute for Health and Care Excellence. Hypertension in adults: diagnosis and management. NICE guideline [NG136]. August 28, 2019. Accessed March 15, 2021. https://www.nice.org.uk/guidance/ng136/chapter/Recommendations#treating-and-monitoring-hypertension

5. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines [published corrections appear in Circulation. 2020; 141(16): e774; Circulation. 2020;141(4):e60; and Circulation. 2019;140(11):e649–e650]. Circulation. 2019;140(11):e596–e646.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at https://www.aafp.org/afp/cochrane.

 

 

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