Should Resistance Training Also Be Considered a Mandatory Component?

I have read with interest the Brazilian Guidelines for Hypertension 2025, specifically Chapter 6: Nonpharmacological Measures (Physical Activity and Exercise). Although the current guideline has interesting practical applications for endurance training, some methodological issues might be of interest to readers, especially regarding the practice of resistance training (RT) for hypertensive patients.

The guideline states that aerobic training is a mandatory component, whereas RT is considered only complementary. However, this approach underestimates the clinical relevance of RT. Recent international guidelines^– recommend a structured exercise program that includes both aerobic exercise and/or RT. Notably, the Japanese Society of Hypertension highlights that regular aerobic and RT are equally effective in lowering blood pressure, and both are therefore strongly recommended.

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