High Blood Pressure Dips With Exercise : Lifestyle: Researchers say regular, moderate activity can reduce or head off mild to moderate hypertension. They suggest 20 to 60 minutes three to five times a week.

WASHINGTON —  Your feet may be your best weapon against rising blood pressure.

Regular, moderate-intensity endurance exercise can reduce mild to moderate hypertension and can help people who don’t have high blood pressure avoid getting it, according to the American College of Sports Medicine.

This makes 20 to 60 minutes of exercise three to five times a week a good idea for people with essential hypertension, in which the condition has no obvious cause, a position paper by the ACSM said.

“Get out for a good half-hour walk every other day,” advised James Hagberg, who chaired the committee that wrote the paper.

The recommendation is in line with an earlier position paper by the ACSM and the federal Centers for Disease Control and Prevention, said Hagberg, a professor of medicine at the University of Pittsburgh School of Medicine. That report said moderate exercise is an excellent way to stay healthy.

The ACSM position paper defines mild to moderate high blood pressure as readings of 140 to 180 on the systolic, or contracting, part of the heartbeat, or 90 to 105 on the diastolic, or relaxing, part.

The risk of heart disease and stroke goes down as high blood pressure falls. So exercise could be especially important for those on the upper end of the ACSM target range.

Compared with peers who have normal blood pressure, men and women with readings above 160/95 have a 150% to 300% higher annual rate of contracting heart disease, the paper said.

Exercise training can lower blood pressure by an average of 10 points in systolic and diastolic readings, the report said. That’s comparable with some drug therapies, Hagberg said, adding: “It’s a tremendously valuable reduction.”

But exercise seems to have special value in people with mild to moderate hypertension. The ACSM recommends that doctors, before deciding to rely on drugs, push their patients to exercise.

Exercise generally mixes well with medication for hypertension, the position paper said. But there are exceptions, notably beta-blockers, which limit increases in systolic pressure, it said. So it recommends that doctors who want a patient to exercise find out whether they can meet the patient’s medication needs with something other than beta-blockers.

Doctors are still debating whether aggressive drug therapy does reduce the cardiovascular risk, the paper said.

Exercise, on the other hand, doesn’t have drugs’ side effects. It’s also cheaper--a program of walking requires nothing more than a pair of good walking shoes.

Exactly how aerobic exercise results in lower blood pressure is something of a mystery, Hagberg said. It could make blood vessels widen or reduce the amount of blood that has to be pumped through the heart, he said.

Some studies indicate there are some groups who can’t expect exercise alone to drive down blood pressure, the report said. Among them are the overweight. But even with them, the facts are not certain, the paper said.

And the overweight may have a special need for exercise, because it burns calories, which can help bring their weight down, the report said.

That’s important because obesity is the most important thing a person can control, said Dr. Robert M. Carey, dean of the University of Virginia School of Medicine, commenting on the paper.

“Exercise is important, and exercise and diet together do result in weight loss in most patients,” he said. “If you can do nothing else, (do) weight reduction, weight reduction, weight reduction.”

The findings in the ACSM paper are in line with American Heart Assn. recommendations, Carey said.