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Summary and Recommendations for Those with Hypertension/Cardiovascular Disease


Summary: Hypertension is classified by having a persistent elevation in either systolic blood pressure greater than 130mm HG or a diastolic blood pressure greater than 80mm HG. Blood pressure is controlled by two factors: cardiac output (your heart rate and volume of oxygenated blood being pushed through the heart to the body) or peripheral vascular resistance.This means that there is some sort of partial blockage (buildup of plaque inside of the arteries) that is causing your blood pressure to rise. This partial blockage is caused by a condition called Atherosclerosis. Atherosclerosis makes your artery walls stiff and tight which leads to chronic vasoconstriction (shrinking of open space in vasculature) which directly increases your blood pressure by narrowing the width of passage for blood to travel. Hypertension can also be causes by genetic factors that are inherited from either parent, and cause hypertensive conditions with seemingly no direct cause.

Process of Atherosclerosis

As LDL-Cholesterol (Low Density Lipoprotein) builds in the arterial walls, immune cells (Macrophages in this case) encapsulate the cholesterol and begin the formation of Foam Cells. This forms a hard surfaced plaque within the Arteries, that can cause an increase in blood pressure and also increases the chance of a stroke as blood clots can get stuck between the plaque and the arterial wall. The Plaque can also “break off” and cause potential embolisms or heart attacks.

What are the ACSM Exercise Recommendations for Hypertension?

The ACSM recommends 3-7 days of moderate to vigorous exercise (only 3 days if all exercise is vigorous) for 20-60 minutes per session or 180min/Week. These exercises should involve large dynamic muscle groups (walking, running, biking, or swimming).

Facts about Aerobic Training and Cardiovascular Diseases

· Regular aerobic exercise influences epithelial (tissue inside of the arteries) repair and also has shown to decrease resting systolic and diastolic blood pressure by 5-7mm HG.

· Aerobic exercise also has shown to help prevent, slow, and even reverse atherosclerotic plaque development.

· EPCs (Epithelial Progenitor Cells) are released after vigorous exercise to help repair any epithelial tissue tears within the lining of the arteries or vasculature that may have been damaged from exercise. This is believed to be the key to preventing and reversing atherosclerosis as EPCs are released more frequently from vigorous exercise as exercised induced stress hormones signal their release.


Magyari, Peter, et al. ACSMs Resources for the Exercise Physiologist: a Practical Guide for the Health Fitness Professional. Wolters Kluwer Health, 2018.

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