Shafaqna Health:
May 17 marks World Hypertension Day, designated by the World Hypertension League (WHL). Hypertension, which gradually damages blood vessels without notable symptoms, is considered a representative chronic disease that increases the risk of myocardial infarction, stroke, heart failure, and chronic kidney disease. For this reason, the medical community commonly refers to hypertension as a “silent killer.”
Hypertension treatment has traditionally centered on blood pressure medication, but the importance of lifestyle management — particularly exercise — has been growing recently. Even when blood pressure readings are controlled, the risk of cardiovascular disease does not completely disappear. Experts emphasize that consistent physical activity must accompany drug therapy to protect vascular health.
According to the latest issue of the international journal Clinical Hypertension, a research team at Seoul National University’s Institute of Sport Science used National Health Insurance Service data to track 124,370 hypertension patients who underwent national health screenings between 2009 and 2012, with an average follow-up period of 9.1 years.
The researchers analyzed exercise volume in METs (metabolic equivalent of task units) based on the World Health Organization (WHO) recommendation of 150-300 minutes of moderate-intensity exercise or 75-150 minutes of high-intensity exercise per week. The survey found that 55.4% of all hypertension patients failed to meet the recommended exercise levels. More than half of the patients focused on drug treatment but did not exercise sufficiently.
In contrast, clear differences were observed among patients who exercised regularly. The group that met the recommended exercise level of 500-1,000 MET-minutes per week had an 18% lower overall mortality risk than the group that did not exercise at all. The risk of cardiovascular disease death was also analyzed to be 27% lower.
The more exercise, the greater the effect. Among patients who exercised at levels significantly exceeding the recommended standards, the reduction in overall mortality risk was most pronounced. The research team interpreted this as a result of exercise not only lowering blood pressure but also simultaneously improving vascular function and cardiopulmonary fitness.
Regular exercise is known to help restore vascular endothelial function and improve vascular elasticity, as well as reduce insulin resistance and inflammatory responses. Combined with weight loss, exercise effectively serves as a “combination prescription” for hypertension patients, the researchers explained.
Notably, the study found that exercise “intensity” was also an important variable. The researchers separately analyzed the proportion of high-intensity exercise — such as running, aerobics, and fast cycling — that causes significant shortness of breath.
As a result, patients whose high-intensity exercise accounted for more than half of their total exercise had a 14% lower overall mortality risk than those who did not. The risk of myocardial infarction was 29% lower, and the risk of ischemic stroke was 16% lower. This suggests that cardiovascular protection effects may be greater when patients combine moderate movement with exercise intense enough to cause some shortness of breath.
However, experts warn that excessive exercise can actually be dangerous. Hypertension patients often have weakened blood vessels, so suddenly engaging in high-intensity exercise can cause blood pressure to rise sharply. Accordingly, it is recommended to start with moderate-intensity exercise such as walking and gradually increase to light jogging or interval training depending on physical condition.
Hypertension is a condition in which systolic blood pressure of 140 mmHg or higher, or diastolic blood pressure of 90 mmHg or higher, persists. Initial symptoms are rare, so many people do not recognize the disease themselves. However, if left untreated for a long period, the risk of severe diseases such as stroke, angina, heart failure, chronic kidney disease, and retinal disease increases.
According to the Korea Disease Control and Prevention Agency, the prevalence of hypertension among adults aged 19 and older last year was 26.3% for men and 17.7% for women. Based on health insurance statistics, the number of hypertension patients in Korea reached 7,605,577 in 2024. The Korean Society of Hypertension estimates that, including undiagnosed patients, the number of hypertension sufferers aged 20 and older in Korea is approximately 13 million.
