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  • New research offers the first personalized advice on the most effective type of exercise to lower blood pressure and reduce the risk of heart attack or stroke.
  • Depending on your blood pressure, different forms of exercise may be best. They include isometric exercises, aerobic exercises, and resistance training.
  • Experts say that by eating whole grains, fruits, and vegetables and avoiding salt can also help keep blood pressure in a healthy range.

Having high blood pressure, or hypertension, significantly increases your risk for heart disease and stroke, the leading causes of death in the United States, according to the Centers for Disease Control and Prevention (CDC).

The CDC also emphasizes that getting at least 2.5 hours of “moderate-intensity” physical exercise per week is an effective way to keep blood pressure in a healthy range.

However, the recommendations are very general. What if there was a way to know exactly which type of exercise is best for your health situation?

Now new research published in the European Journal of Preventive Cardiology offers the first personalized advice on the most effective type of exercise to lower blood pressure and reduce the risk of heart attack or stroke.

The researchers looked at how different forms of exercise, from aerobic to isometric training, could affect high blood pressure.

They broke study participants into groups of high blood pressure, high to healthy blood pressure, and healthy blood pressure.

“The goal of the recommendations for all three groups is primarily to lower blood pressure,” first study author Henner Hanssen, a professor at the University of Basel in Switzerland, said in a statement.

“Ultimately, through blood pressure reduction, we can reduce the risk of heart attack, stroke, and death from cardiovascular disease — thereby spending more years of life in good health,” he said.

According to researchers, for people with a blood pressure of at least 140/90, aerobic exercise was the most effective method. This includes walking, running, cycling, or swimming.

“In people with hypertension, the blood pressure reduction that can be achieved with aerobic exercise is the same, or even slightly more, than taking a single antihypertensive medication,” Hanssen said in the statement.

The group of people with high to healthy blood pressure, also called stage 1 hypertension, is defined as people with a blood pressure reading of 130–139/85–89.

For these people, dynamic resistance training is the first priority, researchers said. This is strength training where muscle contraction results in movement, like lifting weights, squats, and pushups, according to study authors.

However, researchers found that people with healthy blood pressure — less than 130/84 — get the greatest benefit from isometric training, which is the static contraction of muscles.

Examples include the handgrip exercise or wall squat.

“[It] can be considered the resistance that the heart has to pump against,” Guy L. Mintz, MD, Northwell Health’s director of cardiovascular health and lipidology at the Sandra Atlas Bass Heart Hospital in New York, told Healthline.

“The most common cause of hypertension is idiopathic, [meaning] we don’t know why. [This is] about 94 percent of cases,” he said.

According to Mintz, blood pressure can increase with age because our arteries become less flexible.

He added that men tend to have higher blood pressure than women before age 65, but the likelihood of developing hypertension is similar after that age.

Patrick Fratellone, MD, cardiologist at Fratellone Medical Associates in New York, said that hypertension affects more than 108 million people.

Hypertension is defined as a systolic blood pressure reading (the top number) greater than 130 or a diastolic blood pressure reading (the bottom number) over 80 mm Hg.

“As the criteria for blood pressure numbers have decreased, more individuals are being diagnosed with hypertension. Only 24 percent have their blood pressure under control,” he said.

Fratellone explained why regular exercise can help lower blood pressure over time.

“You must understand that regular exercise strengthens your heart,” Fratellone said. “A stronger heart makes the heart pump with less effort. This puts less stress on your arteries, thus lowering blood pressure.”

“High blood pressure is referred to as the ‘silent killer.’ The vast majority of patients have no symptoms,” Mintz said.

He explained that high blood pressure affects health by causing damage to the arteries.

“By increasing the workload on the heart due to its increased resistance, arterial damage accelerates atherosclerosis,” he said.

This is because damaged arteries allow LDL (bad) cholesterol to form plaques that increase heart attack and stroke risk, a condition called atherosclerosis.

“Hypertension also can lead to kidney disease, vision loss, stroke, heart failure, and even sexual dysfunction,” Mintz said.

Fratellone pointed out we have two epidemics in the United States: diabetes and obesity.

“Both lead to heart disease,” he said. “Changing your dietary lifestyle has a tremendous impact on preventing heart disease, as hypertension.”

According to Fratellone, a diet rich in whole grains, fruits, and vegetables can lower both blood pressure and cholesterol levels, reducing the risk of heart disease.

“Lifestyle modification, including proper diet, salt restriction, and exercise, is the foundation for the treatment of hypertension,” Mintz said.

He explained that when the definition of hypertension was lowered to current guidelines, more than two-thirds of U.S. adults 45 to 75 years old became classified as having hypertension.

For people with chronic health conditions in addition to hypertension, there are medical options available.

When choosing a medication to prescribe, your doctor will consider any coexisting conditions you may have, such as diabetes, heart disease, heart failure, and kidney disease, as well as your race, gender, age, and medication side effects profile, Mintz said.

While exercise has long been known to help manage high blood pressure, new research has found the best form of exercise for different stages of the condition.

Depending on how high your blood pressure is, this can involve aerobics, conventional resistance training, and isometric exercise.

Experts say that eating whole grains, fruits, and vegetables and avoiding salt can also help keep blood pressure in a healthy range.

They say that since blood pressure guidelines were adjusted, only about 24 percent of people in the United States are considered to have healthy blood pressure.