GUEST POST BY DR. JIM WRIGHT AND ALAN CASSELS

A recent review published by Cochrane, an international network of researchers who gather evidence to inform decisions about health care interventions, shows that walking may be just as good as anti-hypertensive pills for lowering blood pressure.

The benefits of walking seem obvious: it is something that can fit into your regular day, is low cost and low impact, and is now proven to be as effective as a drug in lowering your blood pressure.

The Taiwanese researchers set out to answer a simple, yet vitally important question: Can walking lower blood pressure?  They scoured the world’s research databases and combined the results into a systematic review.

It’s a question that’s been asked a lot. The researchers found 73 trials involving 5,763 participants aged 16 to 84 in 22 countries. Those trials looked at the effects of walking in males and females across a variety of health conditions, different walking programs and intensity levels.

There was pretty reliable evidence that walking reduces systolic blood pressure (SBP), the top or bigger number, across most age ranges. The reductions were up to 5mm of mercury and in four of the highest quality studies, the effects were up to 8 mm of mercury.  This is similar to the effect of most drugs you’d be prescribed to lower your blood pressure. The most pronounced effects seemed to be in people up to 40 years old.  Only about a quarter of the studies reported any adverse events, with knee injury being the most reported adverse event.

How does this add to what we already know?

High blood pressure, also known as hypertension, is one of the most important risk factors for cardiovascular diseases, such as stroke or heart disease.  We know that lowering blood pressure to safer levels reduces the risks of these diseases. We also know that many things related to our diets and our lifestyle choices, such as whether we smoke, eat a balanced diet or carry around too much weight all increase our risks of many diseases.

High blood pressure is linked to a variety of factors, and lucky for us there are many drugs that can be prescribed to help lower blood pressure.  But like any health intervention, drugs cost money, you have to remember to take them, and they often come with side effects that range from merely bothersome to sometimes life-threatening.

Photo credit: Doctors of BC

What else should we know about blood pressure?

What is too high when it comes to high blood pressure? That answer is probably more controversial than you would think, but it is generally accepted that hypertension is defined by resting readings above about 140/90.

A Canadian survey in people between 20 to 79 found that about 24% of the population are defined as hypertensive with that definition. This increases with age, so that about 50% of Canadians aged 60 to 79 self-reported that they had been diagnosed with hypertension.

This might mean as you get older, there are even more reasons why you should go for that daily walk.  The Cochrane group’s findings suggest that if you walked, at a moderate pace, for 20-40 minutes about three times a week, you can effectively lower your resting blood pressure.  It might not be all you need to do to control your blood pressure, but it is a very good place to start which is why physicians in B.C. are increasingly prescribing exercise to their patients. The next Walk With Your Doc event in B.C. is expected to happen this fall.

The latest Cochrane research reinforces the notion that the walkability of our cities deserves a high priority by our city planners.  One Canadian survey found that adults living in less walkable neighbourhoods had a higher predicted 10‐year cardiovascular disease risk than those living in highly walkable areas.

Dr Jim Wright is the Editor in Chief of Cochrane Hypertension, based in Vancouver.

Alan Cassels is the author of The Cochrane Collaboration: Medicine’s Best Kept Secret. He lives in Victoria.