University Report: The Impact of Walking on Hypertension - Analysis

This report provides a comprehensive literature review on the impact of walking as a physical activity on hypertension. It synthesizes findings from various studies, meta-analyses, and research papers published between 2013 and 2019, focusing on the hypotensive effects of walking and its role in managing blood pressure. The report explores the methodology used, including the search terms and databases, and presents a detailed analysis of the reviewed literature, covering topics such as the recommended step count for health benefits, the effects of guided walking programs, and the impact of walking intensity and duration on blood pressure. The review also examines the effects of walking in different populations, including middle-aged adults, older adults, and pregnant women, highlighting the potential of walking as a safe and effective strategy for reducing blood pressure and improving overall cardiovascular health. The report concludes that regular walking can be a beneficial intervention for individuals at risk of hypertension, and should be considered as part of a public health policy.

Running head: WALKING AS PHYSICAL ACTIVITY
Analysing the Impact of Walking on Hypertension
Name of the Student
Name of the University
Author Note

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Introduction
Hypertension is globally the most severe, expensive, and avoidable risk factor for
cardiovascular diseases. This needs comprehensive treatment and prevention programs. The fact
that regular physical activity decreases blood pressure is grounded on evidence based guidelines.
Recent meta-analysis showed substantial reductions in systolic and diastolic blood pressure in
people who follow regular walking programs (Pescatello et al., 2015). Changes of diet can lower
blood pressure in hypertensive patients, thereby reducing the risk of cardio-vascular disease
(Murtagh et al., 2015). In hypertensive patients with a daily aerobic exercise regimen, a number
of studies have recorded BP decrease. Higher physical exercise has also been shown to be
correlated with less cardiovascular disease risk (Alves et al., 2016). Walking is considered as a
mild to moderate aerobic exercise and can be done with minimal risk for most people (Refer to
Figure 1). Many studies have shown that walking in hypertensive patients has hypotensive
consequences (Espay et al., 2016). Nonetheless, in most experiments investigating the effect of
walking on BP, only regular BP was calculated (Ohta et al., 2015). It has been found that BP
decreases during exercise and reduces after activity is over. Thus, this paper focuses on the
influence of aerobic exercise like walking on blood pressure and will draw evidences from
various papers and journals to support the validity of the research area.
Methodology
Many online repositories including CINAHL, Pub Med and Google Scholar were
scanned for relevant articles related to the field of research in order to carry out this review a
total of 25 papers relating to the topic were discovered, but only 12 of these 25 articles meet the
requirements for inclusion. Those papers that have no definitive conclusions and lack adequate

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research and empirical studies have been withdrawn. The papers have been selected or analyzed
on the basis of information available to them by skimming through the abstract of the paper.
Certain keywords like “walking and blood pressue”, “Aerobic exercise”, “blood pressure non-
pharmacological treatment”, “walking reduces blood pressure”, “hypertension and walking”,
“walking exercise”, “Guided walking for blood pressure’, “Physical Activity and blood pressure”
were searched. The studies included in the review were carried out in 2013-19 in order to obtain
current findings on the particular topic.
Figure 1: Impact of Walking in Controlling Hypertension, Source:
(Naturopathydigest.com., 2019)
Literature review
A healthy aerobic physical activity is a significant element in many educational strategies
for physical activity promotion. Since walking is common and available to anyone at low risk of
injury, costly facilities, appliances or clothes are needless (Pescatello et al., 2015). Walking can
be done independently or in a collective at different intensities and speeds. Higher levels of
cardiorespiratory fitness are correlated with brisk walking. According to Soroush et al. (2013)
studies of public health suggested that taking 10,000 steps a day has significant effects on health.

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About 2,000 kcal of energy is expended every week taking 10,000 steps per day. Thus, this
amount of daily physical exercise is optimized for better health and reduces chronic illnesses
such as obesity and mellitus. The use of pediatric meters to track walks has shown that taking at
least 10,000 steps a day decreases BP and increases the exercise capacity of hypertensive
individuals. The findings from a recent study suggest that for sedentary adults with high blood
pressure, a 6-month controlled walk is efficient at reducing systolic and diastolic blood pressure,
with particularly obvious benefits in those with more extreme blood pressure (Mandini et al.,
2018). After the 6 months walks of the sedentary participants involved in the research, the body
weight, BMI and the waist circumference have been reduced considerably. Such declines are due
to additional calorie expenditures demanded under the walking plan, as found in the
overwhelming majority of participants. However, the improvement in blood pressure of the
walking system does not have a correlation with the decreased body mass index, body weight
and waist circumference which are lowered equally between the specific Systolic blood pressure
subgroups (Mandini et al., 2018). Thus, according to Hanson and Jones (2015) considering that
mild physical activity like walking reduces blood pressure significantly and is correlated with
many other health benefits, guided walking services must be included as normal hypertension
adjunctive treatment.
While walking groups are successful and safe, they must be implemented as part of a
public health policy of strong adherence and wide health benefits (Murtagh et al., 2015). On the
similar ground, the research by Ohta et al (2015) furthermore found that moderate aerobic
exercise not only decreases BP, but also lowers body weight, body fat and
waist circumference and increases the response to insulin and HDL cholesterol level. Regular
exercise for the management of hypertension in recommendations is therefore advised.

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Nevertheless, evidence concerning the exercise-related decrease in BP in general and amongst
population subgroups is inconsistent (Ohta et al., 2015). Previous studies have shown that after a
larger workout rate, a higher exercise intensity and longer duration of post-exercise hypotension
(PEH) have been observed that increased energy expenditure (EE) results with more decreased
BP (Ohta et al., 2015).
Furthermore, a previous study found that a single exercise in medium-aged people with
type-2 diabetes and prehypertension had 24 h BP reduction and this reduction can rely on a
higher intensity of exercises (De Morais et al., 2015). Interestingly, Horiuchi et al. (2015) studied
the association of the expenditure of activity energy and blood pressure changes in individuals
following ‘forest walks’. According to the authors, walking in forests may be beneficial for
human health, but very little knowledge about the impact of energy costs on blood pressure after
walking in forests is available. The study, thus, aims at exploring the effectiveness of forest
walking and its impact on reducing BP. It has been found from the study findings that Forest
walk lowered the overall arterial pressure substantially and strengthened the mood profile in both
groups involved in the study. Greater energy expenditure linked to exercise could be expected to
highlight physiologically beneficial impact on the elderly and the middle-aged. Moreover,
psychological stress can be alleviated by the forest environment per se (Horiuchi et al., 2015).
Essential blood pressure (EP) is described as an increased blood pressure (BP), which
frequently leads to cardiovascular diseases and organ damage. The research by He, Wei and Can
(2018) explores if aerobic exercise programs with varying intensities will minimize BP rise.
According to the authors, brisk walking can also decrease the severity and probability of severe
cardiovascular events in elderly patients having essential hypertension at different intensities of
exercise. Brisk walking is the easiest way to practice, particularly preferred by body builders of

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medium-aged age. The United States Guidelines on Hypertension and the European Guidelines
on Hypertension consider walking as a physical exercise to aid in avoiding EP (He, Wei and
Can, 2018).
The quasi-experimental cohort study by Morimoto et al. (2018) evaluated the effect of a
pedometer assessed on BP and blood glucose levels in overweight people was tested by at least
10,000 average steps every day. In the results of this study that correlates with other reports, the
beneficial decrease in BP was shown (Börjesson et al., 2016). The results confirm that 10,000
steps a day are successful in enhancing physical activity. They confirmed that a 4-month
intervention showed a decrease in systolic and diastolic BP. The outcome of this study showed
that increased physical exercise would decrease levels of blood glucose and mortality related to
diabetes and other associated comorbidities by increasing daily steps (Morimoto et al., 2018).
Furthermore, Khoram et al. (2019) focused on exploring the effectiveness of walking in
decreasing hypertension among a different target group, pregnant women. This is because
pregnancy hypertension is one of the most important unresolved problems in the midwifery;
proactive care steps are necessary to manage this serious complication since it is the main cause
of maternal death. According to the findings, moderate walking should be recommended for
women who are vulnerable to hypertension pregnancy, as a simple physical exercise (Khoram et
al., 2019).
Conclusion
This literature review enabled to evaluate the importance and effectiveness of walking
among different population with hypertension including middle aged adults, older adults and
pregnant women. The above review is supported and grounded on strong and evidence based

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researches conducted on this area to get conclusive findings. Upon conducting the literature
review, it has been found that walking is an effective strategy to reduce blood pressure among a
wide range of population and it should be highly recommended to the individuals at risk. A
regular physical activity or an aerobic exercise strengthens the heart making it pump more blood
requiring lesser effort. This in turn, decreases the force on the arteries that ultimately reduces
blood pressure. An easy way to control high blood pressure could be through aerobic activity like
walking. Nevertheless, stability and increased movements like elevated weights are also key
components of a fitness plan, although they are not addressed in the above literature review. The
primary focus of the review was to evaluate the effectiveness of walking on blood pressure.
Thus, from the above review it can be concluded that habitual walking can safely and effectively
help lower hypertensive individual’s blood pressure without exposing them to potential adverse
effects of drug therapy. Considering that moderate physical exercise like walking reduces blood
pressure and is linked to numerous other medical advantages, guided walking programmes, as
standard hypertension therapy, should be included in the intervention plan. Walking groups with
strong adherence and comprehensive health benefits must be embraced as part of the public
health policy, since they are effective and safe.

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