Trial Summary
What is the purpose of this trial?High blood pressure is a leading risk factor for cardiovascular disease. Traditionally, one of the ways to treat or prevent high blood pressure is to prescribe aerobic exercise training (i.e. brisk walking). Stretching may also be effective because it may cause changes in blood vessel stiffness and therefore reduce resistance to blood flow. The study will assess a group of individuals (i.e. 96) participating in a supervised stretching or walking program five days per week for six months to determine whether stretching is superior for reducing blood pressure. This research will contribute to recommendations about the most effective exercise programs for reducing blood pressure and risk of cardiovascular disease.
What data supports the idea that Stretching vs Walking for High Blood Pressure is an effective treatment?The available research shows that stretching is more effective than brisk walking for reducing blood pressure in people with high-normal blood pressure or stage I hypertension. One study found that after 8 weeks, stretching led to greater reductions in blood pressure compared to walking. Another study involving older women showed that flexibility training, which includes stretching, significantly lowered blood pressure. These findings suggest that stretching can be a beneficial treatment for managing high blood pressure.157910
Do I have to stop taking my current medications for the trial?The trial does not specify if you need to stop taking your current medications. However, if you are on blood pressure medication, it must have been a stable dose for 6 months without achieving target blood pressure.
What safety data exists for stretching and walking exercises for high blood pressure?The studies reviewed indicate that both stretching and walking exercises are generally safe for individuals with high blood pressure. Stretching has been shown to be effective in reducing blood pressure, with no significant adverse hemodynamic responses observed in senior athletes. Additionally, stretching combined with respiratory techniques improved cardiovascular outcomes in hypertensive postmenopausal women. Walking, as a form of aerobic exercise, is also recommended for blood pressure reduction. Overall, both exercises appear to be safe and beneficial for managing high blood pressure.45689
Is stretching exercise a promising treatment for high blood pressure?Yes, stretching exercise is a promising treatment for high blood pressure. Studies show that stretching can be more effective than brisk walking in reducing blood pressure in people with high-normal blood pressure or stage 1 hypertension.23579
Eligibility Criteria
This trial is for adults with high blood pressure who can walk unaided and safely perform exercises. They should have a systolic BP of 130-159 mmHg or diastolic BP of 85-99 mmHg, not be on unstable blood pressure meds, non-smokers, not already active in moderate to vigorous exercise for 150 minutes weekly or involved in flexibility programs.Inclusion Criteria
I can walk by myself for 30 minutes without help.
Treatment Details
The study compares the effects of stretching versus walking exercises on lowering blood pressure over six months. Participants will engage in either a supervised stretching or walking program five days per week to see if stretching offers better outcomes than traditional brisk walking.
2Treatment groups
Experimental Treatment
Group I: WalkingExperimental Treatment1 Intervention
Walking
Group II: StretchingExperimental Treatment1 Intervention
Stretching
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Research locations nearbySelect from list below to view details:
University of SaskatchewanSaskatoon, Canada
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Who is running the clinical trial?
University of SaskatchewanLead Sponsor
Canadian Institutes of Health Research (CIHR)Collaborator
References
Exercise and mild essential hypertension. [2009]The achievement of chronic blood pressure (BP) control in persons with mild hypertension is of central strategic concern in the prevention of hypertension-related morbidity and mortality. Epidemiologic and longitudinal studies suggest that regular participation in physical activity may be beneficial both in preventing hypertension and in lowering an already elevated BP. Moreover, preliminary analyses from our center suggest that cardiorespiratory fitness and, by inference, aerobic exercise may be of benefit in reducing mortality rates in hypertensive patients. When prescribing exercise with the intention of reducing an elevated BP and attenuating the risk for coronary artery disease, several factors must be considered to optimize the likelihood of a safe and effective response. These factors include specific safety aspects, and the type, frequency, intensity, and duration of exercise. In this respect, we recommend that aerobic exercise be performed at an intensity corresponding to 55 and 85% of the maximal heart rate and that the duration and frequency of training be modulated to achieve a weekly energy expenditure of between 14 and 20 kcal/kg of body weight. For those patients who require drug therapy, the interaction between the specific antihypertensive agent and exercise must also be considered.
Walking 10,000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension. [2022]We investigated the effects of walking 10,000 steps/day or more on blood pressure and cardiac autonomic nerve activity in mild essential hypertensive patients. All subjects were males aged 47.0+/-1.0 (mean+/-SEM) years old. The original cohort consisted of 730 people in a manufacturing industry who measured the number of steps they walked each day using a pedometer. Eighty-three of these subjects walked 10,000 steps/day or more for 12 weeks. Thirty-two of these were hypertensives with systolic blood pressure (SBP) greater than 140 mmHg and/or diastolic blood pressure (DBP) greater than 90 mmHg. Thirty of these hypertensive subjects (HT) were examined twice, once during the pre- and once during the post-study period, for body mass index (BMI), maximal oxygen intake (Vo2max), blood pressure, heart rate (HR), and autonomic nerve activity by power spectral analysis of SBP and HR variability. In the HT group, walking 13,510+/-837 steps/day for 12 weeks lowered blood pressure (from 149.3+/-2.7/98.5+/-1.4 to 139.1+/-2.9/90.1+/-1.9 mmHg; p
Reductions in Resting Blood Pressure in Young Adults When Isometric Exercise Is Performed Whilst Walking. [2020]Aerobic and isometric training have been shown to reduce resting blood pressure, but simultaneous aerobic and isometric training have not been studied. The purpose of this study was to compare the changes in resting systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP) after 6 weeks of either (i) simultaneous walking and isometric handgrip exercise (WHG), (ii) walking (WLK), (iii) isometric handgrip exercise (IHG), or control (CON). Forty-eight healthy sedentary participants (age 20.7 ± 1.7 yrs, mass 67.2 ± 10.2 kg, height 176.7 ± 1.2 cm, male n = 26, and female n = 22) were randomly allocated, to one of four groups (n = 12 in each). Training was performed 4 × week-1 and involved either treadmill walking for 30 minutes (WLK), handgrip exercise 3 × 10 s at 20% MVC (IHG), or both performed simultaneously (WHG). Resting SBP, DBP, and MAP were recorded at rest, before and after the 6-week study period. Reductions in resting blood pressure were significantly greater in the simultaneous walking and handgrip group than any other group. These results show that simultaneous walking and handgrip training may have summative effects on reductions in resting blood pressure.
Additional Improvement of Respiratory Technique on Vascular Function in Hypertensive Postmenopausal Women Following Yoga or Stretching Video Classes: The YOGINI Study. [2020]Background: Hypertension remains highly prevalent in postmenopausal women, along with vascular dysfunction and increased oxidative stress. In such context, regular exercises, yoga practice, and slow breathing have been recommended to treat hypertension. However, the effects of the multiple components of yoga, including the respiratory techniques involved in the practice, on hypertension and on vascular and endothelial function have never been evaluated. Objective: This study aimed to investigate the additional effects of respiratory technique on vascular function and oxidative stress profile in hypertensive postmenopausal women (HPMWs) following yoga or stretching video classes. Study Design: Hypertensive postmenopausal women were recruited and randomized for 12 weeks, twice a week, of supervised yoga or stretching video classes of 75 min for 12 weeks associated or not with respiratory technique. Baseline and post-intervention measurements included pulse wave velocity (PWV), flow-mediated dilation (FMD), and oxidative stress parameters. Hypertensive postmenopausal women (59 ± 0.7 years) who ended the protocol were distributed into three groups: (1) control group (yoga or stretching, C, n = 14); (2) yoga + respiratory technique (Y+, n = 10); (3) stretching + respiratory technique (S+, n = 9). Results: Diastolic blood pressure and FMD [baseline: C: 6.94 ± 1.97%, Y+: 7.05 ± 1.65%, and S+: 3.54 ± 2.01% vs. post: C: 16.59 ± 3.46% (p = 0.006), Y+: 13.72 ± 2.81% (p = 0.005), and S+: 11.79 ± 0.99% (p = 0.0001)] have significantly increased in all groups when baseline and post-practice values were compared. However, resting heart rate and PWV [baseline: Y+: 10.44 ± 3.69 and S+: 9.50 ± 0.53 m/s vs. post: Y+: 9.45 ± 0.39 (p = 0.003) and S+: 8.02 ± 0.47 m/s (p = 0.003)] decreased significantly only in the Y+ and S+ groups (baseline vs. post). Systemic antioxidant enzyme activities (superoxide dismutase and catalase) increased in all groups, and hydrogen peroxide and lipoperoxidation reduced in Y+ and S+ (baseline vs. post). Conclusions: Twelve weeks of yoga or stretching video classes promoted positive changes in several outcomes generally regarded as cardiovascular risk factors in HPMWs, and these changes were even more pronounced by the association with respiratory technique.
Stretching is Superior to Brisk Walking for Reducing Blood Pressure in People With High-Normal Blood Pressure or Stage I Hypertension. [2023]Aerobic exercise is recommended for reducing blood pressure; however, recent studies indicate that stretching may also be effective. The authors compared 8 weeks of stretching versus walking exercise in men and women with high-normal blood pressure or stage 1 hypertension (ie, 130/85-159/99 mm Hg).
Acute Hemodynamic Responses to Three Types of Hamstrings Stretching in Senior Athletes. [2022]Although stretching is recommended for fitness and health, there is little research on the effects of different stretching routines on hemodynamic responses of senior adults. It is not clear whether stretching can be considered an aerobic exercise stimulus or may be contraindicated for the elderly. The purpose of this study was to compare the effect of three stretching techniques; contract/relax proprioceptive neuromuscular facilitation (PNF), passive straight-leg raise (SLR), and static sit-and-reach (SR) on heart rate (HR) and blood pressure (BP) in senior athletes (119 participants: 65.6 ± 7.6 yrs.). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and HR measurements were taken at baseline (after 5-minutes in a supine position), 45 and 90-seconds, during the stretch, and 2-minutes after stretching. Within each stretching group, (SLR, PNF, and SR) DBP, MAP and HR at pre-test and 2-min post-stretch were lower than at 45-s and 90-s during the stretch. SLR induced smaller increases in DBP and MAP than PNF and SR, whereas PNF elicited lower HR responses than SR. In conclusion, trained senior adult athletes experienced small to moderate magnitude increases of hemodynamic responses with SLR, SR and PNF stretching, which recovered to baseline values within 2-min after stretching. Furthermore, the passive SLR induced smaller increases in BP than PNF and SR, while PNF elicited lower HR responses than SR. These increases in hemodynamic responses (HR and BP) were not of a magnitude to be clinically significant, provide an aerobic exercise stimulus or warrant concerns for most senior athletes.
Compliance of Static Stretching and the Effect on Blood Pressure and Arteriosclerosis Index in Hypertensive Patients. [2023]Background: Treatment of high blood pressure is a combination of lifestyle changes and medications, and appropriateexercise therapy is recommended as one of the lifestyle-related changes. Recently, stretching, a low-intensity exercise, was reported to be antihypertensive and effective for improving arteriosclerosis, in addition to aerobic exercise. The present study investigated the short-term effects of continuous stretching and rest-induced rebound on vascular endothelial function in hypertensive patients. Methods: This study was conducted as a single-arm prospective interventional study including patients between 30 and 70 years of age undergoing treatment for hypertension from October 2019 until May 2021. The intervention consisted of six months of daily stretching, one month of rest, and another three months of stretching. We measured arteriosclerosis indices such as cardio ankle vascular index (CAVI), ankle brachial pressure index (ABI) and reactive hyperemia index (RHI), and flexibility at the baseline and one, three, six, seven, and ten months from the baseline. Results: We included a total of ten patients (three males and seven females) with an average age of 60.10 ± 6.05 years. The exercise rate for the entire period was 90% or more, and the anteflexion measurement value improved significantly before and after the intervention (p
Acute Effects of Static Stretching Combined with Vibration and Nonvibration Foam Rolling on the Cardiovascular Responses and Functional Fitness of Older Women with Prehypertension. [2022]We compared the effects of three warm-up protocols (static stretching (SS), static stretching with vibration foam rolling (SS + VFR), and static stretching with nonvibration foam rolling (SS + FR) on the blood pressure and functional fitness performance in older women with prehypertension. Thirteen older women went through different protocols in separate visits, and their systolic (SBP) and diastolic (DBP) blood pressure, heart rate, mean arterial pressure, brachial pulse pressure (BPP), functional fitness test (back scratch (BS), chair-sit-and-reach, 30 s arm curl (AC), 30 s chair stand, 2 min step, 8-foot up and go), and single-leg standing balance (SLB) were recorded. The SBP and BPP were significantly higher after SS and SS + VFR than after SS + FR. Both SS + FR and SS + VFR significantly improved the 2 min step, when compared with SS. Additionally, SS + VFR significantly improved the BS and AC performance. However, compared with SS and SS + FR, SS + VFR significantly reduced the SLB performance. Therefore, SS + FR may be a better warm-up protocol for older women in maintaining blood pressure. On the other hand, even though SS + VFR induced superior shoulder flexibility, aerobic endurance, and arm strength, it could impair balance.
Erratum: Ko et al. (2021). [2023]In the article Ko J, Deprez D, Shaw K, Alcorn J, Hadjistavropoulos T, Tomczak C, Foulds H, Chilibeck PD. Stretching is superior to brisk walking for reducing blood pressure in people with high–normal blood pressure or stage I hypertension. J Phys Act Health. 2021;18(1):21-28. https://doi.org/10.1123/jpah.2020-0365, the clinical trial registration number was incorrectly listed in the text and acknowledgments as NCT02391779; the correct registration number is NCT03947996. The online version of this article has been corrected. The authors regret this error.
Fourteen weeks of multicomponent training associated with flexibility training modifies postural alignment, joint range of motion and modulates blood pressure in physically inactive older women: a randomized clinical trial. [2023]Background: Body relaxation and pain reduction are some of the reported benefits of flexibility training (through active stretching exercises), however their effects on posture and blood circulation are uncertain. We aimed to investigate the effects of flexibility training (through active stretching exercises) in combination with multicomponent training (MT) on blood pressure (BP), and the correlation with changes in body alignment and flexibility in physically inactive women. Methods: Women aged 60-70 years were into three groups: multicomponent training group (MT), multicomponent training plus flexibility training group (FT), and control group (CG). After randomization, the resting blood pressure was measured and the participants were reallocated into subgroups according to pressure values >130/80 mmHg (This classification is according to the American Heart Association (AHA), resulting in the subgroups: flexibility training (FT); flexibility training for hypertensive patients (FTSAH); multicomponent training (MT); multicomponent training for hypertensive patients (MTSAH); control group (CG); control group of hypertensive patients (CGSAH). The interventions lasted 14 weeks. Systolic (sBP) and diastolic (dBP) BP, range of motion (flexion and extension), and postural analysis by asymmetry in the frontal plane and asymmetry in the sagittal plane, displacement and the flexibility test were collected before (Pre) and after training (Post). In total, 141 women participated in the study (without SAH: FT = 23, MT = 20, and CG = 21; with SAH: FTSAH = 28, MTSAH = 23, and CGSAH = 26). Results: Systolic blood pressure, in the pre and post moments were: FT (116 ± 6.7 vs. 114 ± 4.7); FTSAH (144 ± 16.5 vs. 121 ± 10.1); MT: (120 ± 6.8 vs. 121 ± 7.3); MTSAH: (137 ± 10.6 vs. 126 ± 13.0); CG: (122 ± 5.3 vs. 133 ± 19.2); and CGSAH: (140 ± 9.7 vs. 143 ± 26.2), presenting an F value (p-value - group x time) of 12.00 (<0.001), with improvement in the groups who trained. The diastolic blood pressure in the pre and post moments were: FT (71 ± 4.7 vs. 74 ± 6.8); FTSAH (88 ± 9.6 vs. 70 ± 12.0); MT: (74 ± 4.5 vs. 77 ± 11.7); MTSAH: (76 ± 10.4 vs. 76 ± 10.2); CG: (69 ± 7.11 vs. 82 ± 11.4); and CGSAH: (76 ± 13.4 vs. 86.6 ± 7.7), presenting an F value (p-value - group x time) of 8.00 (p < 0.001), with improvement in the groups who trained. In the Elastic Net Regression, sBP was influenced by height (β: -0.044); hip flexion (β: 0.071); Shoulder extension (β: 0.104); low back flexion (β: 0.119) and dBP (β: 0.115). In the Elastic Net Regression, dBP was influenced by asymmetry in the sagittal plane variables (0.040); asymmetry in the frontal plane (β: 0.007); knee flexion (β: -0.398); BM (β: 0.007); Shoulder flexion (β: -0.142); Hip flexion (β: -0.004); sBP (β: 0.155) and Ankle Flexion (β: -0.001). Conclusion: The displacement of the asymmetry in the frontal plane and asymmetry in the sagittal plane, and the increase in the flexion position in the hip, lumbar, head, and knee regions, influenced the highest-pressure levels. Multicomponent training associated with flexibility training promoted improvement in body alignment, COM, and joint angles, and decreased blood pressure.