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Low-intensity walking as mild medication for pressure control in prehypertensive and hypertensive subjects: how far shall we wander?


Successful prevention and treatment of hypertension depend on the appropriate combination of antihypertensive drug therapy and nondrug lifestyle modification. While most hypertension guidelines recommend moderate- to high-intensity exercise, we decided to explore a mild yet effective type of exercise to add to hypertension management, especially in populations with complications or frailty. After comparing the short-term cardiovascular effects of low-speed walking versus high-speed walking for 3 kilometers (km) (3 km/h versus 6 km/h) in young, healthy volunteers, we delivered low-speed walking (low-intensity walking, 2.5 metabolic equivalents of task, METs) as exercise therapy in 42 prehypertensive and 43 hypertensive subjects. We found that one session of 3 km low-intensity walking exerted a transient pressure-lowering effect as well as a mild negative chronotropic effect on heart rate in both the prehypertensive and hypertensive subjects; these short-term benefits on blood pressure and heart rate were accompanied by a brief increase in urine β-endorphin output. Then we prescribed regular low-intensity walking with a target exercise dose (exercise volume) of 500–1000 METs·min/week (50–60 min/day and 5–7 times/week) in hypertensive subjects in addition to their daily activities. Regular low-intensity walking also showed mild but significant blood pressure-lowering and heart rate-reducing effects in 7 hypertensive subjects within two months. It is hypothesized that regular low-intensity exercise of the necessary dose could be taken as a pragmatic and supplementary medication for hypertension management.

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The study was supported by grants from the National Natural Science Foundation of China (No. 30971154, 31171099). We sincerely appreciate Ms. Min-shu Wu for her creative discussion and suggestions. The authors are very grateful to all the volunteers who joined our study without any material incentives, and also to Mr. Haiyang Zhang for his assistance in the picture drawing.

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Correspondence to Hong Chen.

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  • hypertension
  • prehypertension
  • exercise medication
  • low-intensity walking
  • metabolic equivalent of task
  • blood pressure
  • heart rate
  • urine β-endorphin

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