This Rx costs $0.

Nearly half of all American are currently living with hypertension, according to the latest data from the Centers for Disease Control and Prevention.

A large proportion of the 37 million Americans with moderate hypertension (120 to 139 mmHg/80 to 89 mmHg) are put on blood pressure-lowering drugs.

But instead of hopping immediately to prescribing statins, the American Heart Association and the American College of Cardiology have recently issued a new protocol, which was just published as a scientific statement in the journal Hypertension. The best first course of action, they say, is to prescribe something that's totally free and just so happens to be pill-free, too: exercise.

Sitting less and moving more is the best first line of defense against mild to moderate hypertension and elevated cholesterol, the cardiologists advise. Earlier research has proven that physically active people have a 21% lower risk of developing cardiovascular disease and a 36% lower risk of dying as a result.

"The current American Heart Association guidelines for diagnosing high blood pressure and cholesterol recognize that otherwise healthy individuals with mildly or moderately elevated levels of these cardiovascular risk factors should actively attempt to reduce these risks," says Bethany Barone Gibbs, Ph.D., an associate professor at the University of Pittsburgh and the chair of the group who wrote the paper. "The first treatment strategy for many of these patients should be healthy lifestyle changes, beginning with increasing physical activity."

A watercolor painting of a heart with a blood pressure pump and gauge
Credit: Getty Images / KsushaArt / Matt Wimsatt

So what is the ideal exercise prescription for those with moderate hypertension and cholesterol challenges? The same amount that's recommended by the Department of Health and Human Services in the current Physical Activity Guidelines for Americans: 150 minutes of moderate or 75 minutes of vigorous aerobic activity each week, plus full-body strength training at least twice weekly. (ICYMI, these 6 super-effective at-home exercises are completely free!)

This level of activity can lower systolic blood pressure (the first number) by 4 mmHg, diastolic blood pressure (the second number) by 3 mmHG, LDL cholesterol by 3 to 4 mg/dL and triglycerides by 4 to 12 mg/dL.

"I think more than the absolute drop that somebody might see from the exercise, it's just the drop in your cardiovascular risk," cardiologist Jennifer Wong, M.D. tells Medical News Today, addressing those who might be thinking those changes seem small.

"Even greater health benefits are realized by exceeding these recommendations," the authors say.

If you don't hit that mark, though, you're still moving the needle, Gibbs adds in a Medical News Today interview: "Every little bit of activity is better than none. Even small initial increases of 5 to 10 minutes a day can yield health benefits." (P.S. Discover how to hack your routine and find moments to exercise when you think you have zero time.)

Just as doctors prescribe medications, the statement authors suggest that doctors prescribe this amount of aerobic and strength training exercise and mention being active at every appointment. They also encourage doctors to:

  • Offer tips about ways a patient can increase and maintain their physical activity levels
  • Nudge patients to spend more time performing physical activities that they enjoy (or keep trying new things until they find one they dig)
  • Offer verbal positive feedback for any noted increases in exercise

While enough is important, just like with many things in life, too much of a good thing can be not so good. Here's how to tell when it's time for a rest day as you ramp up, plus some active rest day ideas to still get some steps in.