較佳之體適能狀態，能夠預防高血壓的發生
流行病學研究已經證明，身體活動/體適能與血壓控制/高血壓乃呈現反比關係 (40)。體適能（透過客觀檢測）有益於減少因隨年齡增長而上升之血壓，進而預防高血壓的發生，青壯年冠狀動脈風險發展（Coronary Artery Risk Development in Young Adults，CARDIA）研究即顯示 (43)，在18〜30歲健康族群中，體適能前20%組於15年後發生高血壓的風險是體適能後20%組的三分之一；且調整BMI後，則為二分之一，風險會根據體適能的變化而變化。
20到90歲的男性經隨訪，經3到28年後發現，具較高的體適能者收縮壓（systolic
blood pressure，SBP）隨年紀上升的幅度減緩，同時延緩高血壓發生的時間 (44)。
運動的投入，對改善血壓與肥胖控制是需要的
許多臨床試驗已屢屢驗證身體活動有利於降低血壓，包含動態 (dynamic) 阻力訓練 (18,21)、靜態等長運動 (18,19,20,25)，以及動態有氧運動 (18,20,22)，其對收縮壓平均下降幅度，在成人正常血壓為2〜4 mm Hg，高血壓患者則是5〜8 mm Hg (18)。大多數試驗的持續時間相對較短，但身體活動的增加已被視為用於降低血壓和預防高血壓的長期減肥干預措施，不可或缺的一部分 (3,4,12)。
筆者: 一般而言，體適能的提升與訓練過程其本質便有助於心血管狀況，文章中也講到一件事，單看血壓數值的下降其介入試驗多半時間較短，而同時，我們從流行病學發現，長期下來的觀察有較低之高血壓發生。高血壓的成因絕大多數是生活因素所引起，那麼面對它也是需要從生活因素去著手，讓運動訓練成為生活習慣，由我們自己決定是否要讓身體避免慢性病，進而健康促進，持續變好。
前段 (Causes of Hypertension 5.2.4)引用論文:
40. Lesniak KT, Dubbert PM. Exercise and hypertension. Curr Opin Cardiol. 2001;16:356-9.
43. Carnethon MR, Gidding SS, Nehgme R, et al. Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. JAMA. 2003;290:3092-100.
44. Liu J, Sui X, Lavie CJ, et al. Effects of cardiorespiratory fitness on blood pressure trajectory with aging in a cohort of healthy men. J Am Coll Cardiol. 2014;64:1245-53
後段 (Nonpharmacological Interventions 6.2)引用論文
3. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the Trials of Hypertension Prevention, Phase I. JAMA. 1992;267:1213-20.
4. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. The Trials of Hypertension Prevention Collaborative Research Group. Arch Intern Med. 1997;157:657-67.
12. Whelton PK, Appel LJ, Espeland MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA. 1998;279:839-46.
18. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2:e004473.
19. Carlson DJ, Dieberg G, Hess NC, et al. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc. 2014;89:327-34.
20. Garcia-Hermoso A, Saavedra JM, Escalante Y. Effects of exercise on resting blood pressure in obese children: a meta-analysis of randomized controlled trials. Obes Rev. 2013;14:919-28.
21. Rossi AM, Moullec G, Lavoie KL, et al. The evolution of a Canadian Hypertension Education Program recommendation: the impact of resistance training on resting blood pressure in adults as an example. Can J Cardiol. 2013;29:622-7.
22. Whelton SP, Chin A, Xin X, et al. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136:493-503.
25. Stewart SH, Latham PK, Miller PM, et al. Blood pressure reduction during treatment for alcohol dependence: results from the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study. Addiction. 2008;103:1622-8.
