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Abstract
Hypertension (HTN) is defined as a systolic blood pressure (SBP) ≥140mmHg and/or diastolic pressure (DBP) ≥90mmHg, and/or taking antihypertensive medication (1) (see Table 1). The Seventh Joint Committee Blood Pressure Classifications (JNC7) added a new category of blood pressure classification, prehypertension, due to the increased risk of cardiovascular complications associated with above normal blood pressure levels (2). Approximately 30% of adults in the United States that are ≥20 years of age have prehypertension (an untreated SBP of 120-139 mmHg and/or DBP of 80-89 mmHg) and are twice as likely to develop HTN (3). HTN affects one in three adults in the United States (1) and is prevalent in one billion individuals worldwide (2). HTN is the most commonly diagnosed cardiovascular condition (1) and is a major risk factor for heart disease, stroke, congestive heart failure, and kidney disease (3). However, approximately one in five individuals who have HTN are unaware and go undiagnosed. (3).
Exercise lowers blood pressure 5-7mmHg among those with HTN (9) and 2-3 mmHg among those with prehypertension (10). Although increasing physical activity is an important recommendation for reducing HTN, less than 50% of Americans engage in the amount recommended to lower blood pressure (3). By not meeting these minimal recommendations, physical activity is under utilized as an antihypertensive therapy.
In addition to lifestyle modifications, antihypertensive medications are prescribed to control HTN (4). Approximately 70% of individuals with HTN use antihypertensive medication to control blood pressure (5). Thiazide-type diuretics have been the basis of antihypertensive therapy to lower blood pressure compared to placebo, followed by angiotensin inhibitors, aldosterone receptor blockers, beta blockers and calcium channel blockers (2). These antihypertensive medications have successfully reduced elevated blood pressure levels, as well as reduce the complications of HTN (2). However, less than half (46.6%) of the individuals who use antihypertensive medications have controlled blood pressure levels (3).
