Can high fitness reduce the risk of heart disease in hypertensive patients? What a new study means

How and why is high blood pressure dangerous for cardiovascular health? Is there a direct relationship between blood pressure and cardiovascular disease?

High blood pressure leads to an increased load on the heart and blood vessels, which in the long-term results in permanent damage. There is a direct correlation between an increase in blood pressure with various cardiovascular diseases such as heart attack, heart failure, brain stroke or paralysis, renal failure, and other vascular diseases.

Is hypertension one of the major causes/risk factors for heart attack and stroke and the leading cause of premature death? Could you give us some data or instances?

Hypertension is a major risk factor for heart attacks. If one has a 6 mmHg fall in blood pressure, there is a 16 per cent reduction in cardiovascular events and a 42 per cent reduction in brain stroke. This is the impact of a reduction in high blood pressure. Hypertension is directly responsible for 57 per cent of all stroke deaths and 24 per cent of all cardiac deaths.

What are the parameters of cardio-respiratory fitness?

The term cardio-respiratory fitness (CRF) includes the fitness of three organs – the heart, lungs and muscles. A person with high CRF can perform strenuous physical activity because of the ability of the heart to pump more blood with each heartbeat. The lung, too, is able to mix more oxygen with blood and muscles can efficiently have a workout without fatigue or tiredness. Various parameters used to assess an individual CRF include maximum oxygen uptake (VO2 Max), rise in heart rate, blood pressure and respiratory rate, and time for exhaustion during exercise.

What are the main causes of high blood pressure? Is obesity a factor? Do age and genetics also play a role?

About 25 per cent of the urban and 10 per cent of the rural adult population suffer from high blood
pressure. Low physical activity, high body weight, increased salt
and alcohol intake, smoking, advanced age, and genetic susceptibility are a few important reasons for high blood pressure.

What is high sensitivity C-reactive protein (a marker of inflammation) and its role in high BP and cardiovascular disease?

High Sensitivity C-reactive protein (hs-CRP) is a blood marker for generalised inflammation in the body of an individual. An abnormal metabolic milieu of the body due to poor dietary habits, increased weight, low physical activities, diabetes, chronic non-cardiac diseases and so on increases the level of hs-CRP, which adversely affects cardiovascular health.

How is high cardiorespiratory fitness linked with greater longevity? Is it true? What are your suggestions to improve it?

Physical activity and regular exercise are always helpful in maintaining good physical and mental health. A regular exercise regimen like jogging, cycling, swimming, and outdoor games like badminton, table tennis and so on help maintain high CRF. Try to spare time to take more steps/walking every day. A goal of 10,000 steps/day before sleeping at night is a good way to have high CRF. High CRF is associated with a decrease in weight, a decrease in blood pressure, low hs-CRP blood marker levels and low blood sugar and cholesterol levels, which improve cardiovascular health.

What are the readings for normal blood pressure in men and women? And what are the levels of high blood pressure? Apart from stroke, and cardiovascular disease, how can high blood pressure affect our health?

In general, the blood pressure should be lower than 140/90 mmHg. If someone has a blood pressure that is higher than the recommended level of 140/90mmHg, he or she should make certain lifestyle modifications such as reducing weight (body mass index should be less than 25Kg/m2), regularising exercises, limiting salt and calories intake, increasing the content of fruits and vegetables in the diet and so on. A physician’s advice is a must for persistent high blood pressure to avoid its long-term side effects on cardiovascular health. It is imperative for people with cardiovascular disease to maintain their blood pressure levels.

What are your suggestions for those who don’t have heart issues?

Patients with underlying cardiovascular diseases such as heart attack, renal failure, stroke and diabetes should be more cautious about high blood pressure as it is more harmful to them compared to those without these diseases. Aggressive control of blood pressure, good drug compliance for years, and regular health checkups are necessary for those suffering from underlying cardiovascular diseases with hypertension. Those individuals with only hypertension and without underlying cardiovascular diseases should have healthy dietary habits, have high CRF by doing regular exercises, maintain their body weight, have regular screening for various risk factors such as high blood cholesterol/sugar, and have regular blood pressure monitoring/recording.

Is vigorous exercise recommended for people with high blood pressure and heart disease? If not, what can they do to improve fitness levels, control their blood pressure and keep their heart healthy? What is the role of diet?

Without the effective control and treatment of high blood pressure and underlying heart disease, none of the individuals should be involved in strenuous exercise/gym activities. On the other hand, each healthy individual should have a routine and regular cardiovascular fitness check-up after the age of 40 years. It’s only after the advice of a physician, that an individual should get involved in a strenuous exercise regimen. Those less than 40 years of age, but with certain risk factors such as smoking, hypertension, diabetes, obesity and a family history of heart disease should check their cardiovascular fitness following a physician’s consultation prior to indulging in strenuous gym/exercise activities.

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