Breakthrough study reveals how much exercise you need to keep blood pressure in check

Young adults must prioritize staying active to reduce their risk of developing hypertension, a condition that can lead to serious health problems such as heart attack, stroke, and dementia later in life.

Current health guidelines suggest that adults should engage in at least two-and-a-half hours of moderate exercise per week, but new research indicates that increasing this to five hours weekly could provide even better protection—especially when maintained throughout adulthood.

A study published in the American Journal of Preventive Medicine followed approximately 5,000 adults, ages 18 to 30, over a span of 30 years. Participants were asked about their exercise habits, as well as medical history, smoking, and alcohol use. Throughout the study, their blood pressure, weight, cholesterol, and triglycerides were also monitored.

Hypertension was defined based on the 2017 standards set by the American College of Cardiology and the American Heart Association, where blood pressure readings of 130 over 80 mmHg or higher are considered hypertensive. This definition provided a framework to assess how participants' exercise routines impacted their cardiovascular health.

The participants, part of the Coronary Artery Risk Development in Young Adults (CARDIA) study, came from urban centers across Birmingham, Alabama, Chicago, Minneapolis, and Oakland, California. Just over half of the group was Black (51.6%), while the rest were white. About 45.5% were men. As these adults aged, their levels of physical activity were tracked, revealing that maintaining or increasing exercise levels into midlife had a direct correlation with better heart health outcomes.

The study revealed significant differences in exercise habits across racial and gender lines. Early on, Black men had the highest levels of physical activity, outperforming both Black women and white women, and slightly exceeding white men.

By the time these Black men reached age 60, however, their physical activity had dropped from about 560 exercise units—a measure used in the study to track activity—to around 300 units. This was just the minimum of two-and-a-half hours per week recommended by the U.S. Department of Health and Human Services.

By comparison, white men maintained a higher level of activity at approximately 430 units, while white women exercised around 320 units. Black women, however, consistently exhibited the lowest levels of physical activity, with their average dropping to less than 200 units by the study’s end.

Dr. Jason Nagata, first author of the study and a physician at UCSF Benioff Children’s Hospitals, noted that “although Black male youth may have high engagement in sports, socioeconomic factors, neighborhood environments, and work or family responsibilities may prevent continued engagement in physical activity through adulthood.” He added that Black men also had higher rates of smoking, which likely reduced their ability to stay physically active over time.

White men, in contrast, experienced a decline in physical activity during their 20s and 30s, after which it stabilized around age 40. White women saw a more gradual decrease, with their physical activity remaining consistent after age 30.

As physical activity declined, so did participants’ cardiovascular health. The study found that 80% to 90% of Black participants, both men and women, had developed hypertension by age 60. In comparison, hypertension rates were lower among white participants, with about 70% of white men and 50% of white women being diagnosed with high blood pressure.

These findings align with previous research, which shows that regular exercise can lower blood pressure. Dr. Kirsten Bibbins-Domingo, senior author of the study and a professor at UCSF, explained that “exercise lowers blood pressure, suggesting that it may be important to focus on exercise as a way to lower blood pressure in all adults as they approach middle age.”

The study’s results suggest that maintaining physical activity levels in young adulthood—at higher levels than what’s typically recommended—may be key to reducing hypertension risk.

The study highlighted the significant impact that even a moderate increase in exercise can have on hypertension risk. Among the participants, 17.9% had consistently exercised at least five hours per week—double the recommended minimum—during early adulthood. These individuals were found to have an 18% lower likelihood of developing hypertension compared to those who exercised less than five hours per week.

For those who maintained their exercise routines well into their 60s, the results were even more promising. This 11.7% of participants had a significantly lower risk of hypertension, highlighting the long-term benefits of sustained physical activity.

Dr. Nagata emphasized the importance of including physical activity assessments in routine medical checkups, much like blood pressure or cholesterol tests. He also stressed that intervention programs should be targeted at places where people spend much of their time—such as schools, colleges, workplaces, and community centers. This is particularly crucial for Black women, who have been found to have high rates of obesity and smoking, and lower levels of physical activity.

“Nearly half of our participants in young adulthood had suboptimal levels of physical activity,” Nagata said. “This was significantly associated with the onset of hypertension, indicating that we need to raise the minimum standard for physical activity. This might be especially the case after high school when opportunities for physical activity diminish as young adults transition to college, the workforce, and parenthood, and leisure time is eroded.”

The study’s findings suggest that young adults, particularly those at risk of hypertension due to socioeconomic and lifestyle factors, should strive to meet and exceed the current exercise guidelines. While two-and-a-half hours a week may be enough to see some benefits, five hours weekly could offer better protection against hypertension as you age. This is especially important for those who may already be at risk due to factors like smoking or obesity.

Ultimately, the research underlines the importance of staying active throughout your life—not just in your youth. By doing so, you can significantly reduce your risk of hypertension and the serious health issues that come with it.

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