The Japanese saying, “Even a cold stone will warm up if you sit on it for 3 years,” reflects the importance of persistence.
New findings suggest this philosophy also applies to managing hypertension through sustained exercise habits.
Recent research by Yamaji et al. revealed that a continuous 3-year exercise regimen significantly improved endothelial function in patients with hypertension.
This study is the first to assess real-world changes in flow-mediated vasodilation (FMD) between regular exercisers and control groups.
Given that the COVID-19 pandemic disrupted exercise routines globally, these results highlight the critical need for maintaining consistent physical activity to protect vascular health.
Interestingly, Yamaji’s study was conducted and designed prior to the pandemic, offering prescient insight into the long-term value of exercise continuation.
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The Impact of Exercise on Blood Vessel Health
Although sitting duration wasn’t directly analyzed in this study, numerous reports emphasize that longer sedentary time increases mortality risk.
Japanese adults, for example, average 5.3 ± 3.7 hours of sitting on weekdays, with “high-sedentary” individuals often being overweight, unmarried, unemployed, or highly educated.
Reducing prolonged sitting and promoting regular exercise are key strategies to combat hypertension and improve overall cardiovascular outcomes, as discussed in our guide on the impact of increased exercise or no exercise on blood pressure.
Exercise Is Medicine: Beyond Blood Pressure Control
Managing hypertension with antihypertensive medication remains important but doesn’t address root causes.
Behavioral changes—especially consistent exercise—play a foundational role in treating hypertension, type 2 diabetes, cardiovascular disease, cancer, depression, and cognitive decline.
The phrase “Exercise is Medicine” underscores exercise’s broad therapeutic power.
Notably, endothelial function deteriorates with age, making vascular health a direct indicator of biological aging.
The 3-year exercise intervention showed marked improvements in endothelial health, offering tangible proof that continued physical activity mitigates vascular aging.
Exercise, Arterial Stiffness, and FITT-VP Principles
In Yamaji’s study, arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) remained unchanged after 3 years, contrasting with some previous research.
Meta-analyses suggest that aerobic or combined training improves arterial stiffness and endothelial function, but differences in exercise prescriptions complicate direct comparisons.
Incorporating aerobic and resistance training to help lower blood pressure could enhance outcomes beyond what medication alone achieves.
To standardize exercise programs, experts recommend following the FITT-VP framework (Frequency, Intensity, Time, Type, Volume, Progression).
Future studies should adopt this systematic approach to better quantify the effects of exercise regimens on vascular health.
The Challenge of Maintaining Long-Term Exercise Habits
Despite the proven benefits, sustaining a 3-year exercise habit remains challenging.
In Yamaji’s study, 28.7% of participants with exercise habits discontinued during the follow-up period, although this dropout rate was lower than in previous studies, likely due to participant bias.
Modern societies increasingly promote convenience, enabling lifestyles with minimal physical activity.
Understanding how to correctly take and monitor your blood pressure can help individuals stay motivated and engaged in maintaining a healthy exercise routine.
Urban environments, community programs, and societal support must collectively nurture sustainable exercise habits that do not rely solely on individual willpower.
Ultimately, the principle holds true: sustained, small efforts yield lasting health rewards—just as even a cold stone eventually warms after years of persistent sitting.
Robin Backlund is a dedicated journalist and a medical student who has written several articles and essays exposing the falseness and hollowness of online resources in the medical science niche.