Role of physical exercise for the management of arterial hypertension in women

Arterial hypertension (HTN) is a leading cause of morbidity and mortality in the general population, with significant sex and gender-related pathophysiological differences. Women face higher cardiovascular (CV) risk and unfavorable CV remodeling associated with HTN, as compared with men, and have specific risk factors for the development of HTN, i.e. reproductive factors and breast cancer status. Physical exercise (PE) represents a powerful, cost-effective, non-pharmacological treatment for the primary and secondary prevention of HTN. In this regard, much evidence highlighted the potential gender-related differences in terms of exercise-related CV adaptations, along with a significant gender gap concerning adherence to exercise protocols that is significantly lower in women for all age groups worldwide. However, to date, there are no specific, sex-focused recommendations in terms of exercise training in the female population with HTN or at risk of HTN. Given these premises, our review aims to summarize the role of exercise in the management of HTN in women, with a specific focus on pregnancy, menopause and breast cancer scenarios, as well as on cardiac rehabilitation. Our purpose is to underline the need for more sex-specific data to explore the best exercise protocols tailored on each participant's characteristics, to get the greatest benefit and to improve adherence to exercise protocols.