AHA Recommends Physical Activity as a First-Line Treatment for Many Patients with Elevated Blood Pressure, Cholesterol

Bethany Barone Gibbs, PhD

The latest scientific statement from the American Heart Association (AHA) is underlining the importance of physical activity as a first-line treatment for some patients with elevated blood pressure or cholesterol.

The statement, which was composed on behalf of the AHA Council on Lifestyle and Cardiometabolic Health, Council on Cardiovascular and Stroke Nursing, and Council on Clinical Cardiology, outlines patient populations meeting the criteria for lifestyle-only treatment for elevated blood pressure or cholesterol, which encompasses more than 20% and the writing committee highlights is an often-overlooked patient population.

"The current American Heart Association guidelines for diagnosing high blood pressure and cholesterol recognize that otherwise healthy individuals with mildly or moderately elevated levels of these cardiovascular risk factors should actively attempt to reduce these risks. The first treatment strategy for many of these patients should be healthy lifestyle changes beginning with increasing physical activity," said Bethany Barone Gibbs, PhD, chair of the statement writing group and associate professor in the department of health and human development and clinical and translational sciences at the University of Pittsburgh, in a statement.

Titled “Physical Activity as a Critical Component of First Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?,”, the statement, which is broken down into 3 sections, was created with the aim of highlighting at-risk patient groups, describing recommendations, and providing guidance and resources for clinical decision-making.

Using estimates based on current literature, authors underline an estimated 28% of US adults had an LDL score above 70 mg/dL and otherwise low risk of cardiovascular disease, an estimated 21% of US adults had a systolic blood pressure of 120-139 mmHg or diastolic blood pressure between 80-89 mmHg. All of these patients, investigators suggest, are candidates for lifestyle-only interventions as first-line treatment.

Within each of the 3 sections, investigators also provide information related to the impact of various lifestyle interventions on blood pressure and cholesterol levels through references to previous AHA guidelines and other studies.

Among the excerpts of the statement highlighted within the aforementioned statement from the AHA include research indicating physical activity was associated with a 21% lower risk of developing cardiovascular disease and a 36% lower risk of death from cardiovascular causes. Additionally, statement authors referenced the US Department of Health and Human Services 2018 Physical Activity Guidelines for Americans, which recommend a cumulative 150 minutes of moderate-intensity aerobic exercise, or 75 minutes of vigorous aerobic activity weekly plus two or more strength training sessions each week.

Statement authors noted prescribing exercise should include multiple components, such as screening patients, use of a wearable device, providing ideas and resources for patient support, exploring multiple activity options, and encouraging or celebrating small increases in physical activity.

"In our world where physical activity is increasingly engineered out of our lives and the overwhelming default is to sit - and even more so now as the nation and the world is practicing quarantine and isolation to reduce the spread of coronavirus - the message that we must be relentless in our pursuit to 'sit less and move more' throughout the day is more important than ever," added Gibbs.

This scientific statement, “Physical Activity as a Critical Component of FirstLine Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?,” was published in Hypertension.