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Exercises for Hypertension

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As many as 50 million adult Americans have hypertension. It is one of the most prevalent diseases in our society. An abnormal blood pressure is considered a reading of 140/90 millimeters of Mercury (a normal reading is 120/80 mm Hg or below). Unchecked hypertension can lead to strokes and heart failure. It is called a silent killer because many people don't recognize any symptoms until a major event occurs. High blood pressure is more common in blacks and persons with a lower socioeconomic background. There are many risk factors for high blood pressure - such as age, race, heredity, and sex, but the most interesting statistic about this disease is that most of the risk factors - obesity, stress levels, sodium intake, physical inactivity, use of certain drugs - are all controllable.

We are going to take a close look at exercise as a treatment for hypertension. The reason exercise works is because during conditioning, vessels dilate to increase blood supply. This vasodilation reduces the pressure exerted against the artery walls. What exercises are best for doing this? There are many options. One of the more interesting aspects of exercise training in hypertension, is that many types of exercise are beneficial, and conditioning programs for high blood pressure regulation "cross over" into the area of mind body fitness.

Traditional Programs

Studies done in exercise labs report that low intensity walking and cycling programs do very well in reducing blood pressure in mild hypertensive persons. Therefore, many clinically-based programs emphasized moderate aerobic training for blood pressure recovery, and tended to avoid heavy strength training because in weight lifters their systolic blood pressure (the top number) increased substantially. Later research showed that moderate strength programs increased systolic pressure slightly, but after exercise, blood pressure was reduced. Also - avoiding holding one's breath during lifting was also found to reduce blood pressure.

What we have found in the past ten years is that other types of programs may also have an impact on blood pressure control. Basic movement exercises like Tai Chi and Qi Gong have an impact in reducing high blood pressure. Relaxation exercises like meditation and breathing also have tremendous benefits. Chair aerobics, movement therapy, dance therapy, and water aerobics all have been reported to improve blood pressure status to a degree, independent of medication status.

These reports open the door for many seniors who may be suffering from even mild high blood pressure to begin a low level program of breathing, movement, and light aerobic and strength programs as part of their commitment to reduce their blood pressure.

So - what is a good program for blood pressure reduction? Starting off with Week 1-2 of daily walking (goal is 5-6 days per week) along with five minutes of stretches and breathing exercises afterwards. The next two weeks entail light dumb bell exercises for chest, back, and hips along with moderate aerobics. After the first month - try a new exercise. Incorporate yoga videos, or relaxation cassettes into your workout. Remember to monitor your pressure with a home blood pressure cuff. It is the easiest way to record your pressure levels before and after exercise.

Remember to monitor blood pressure readings after exercise

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Your doctor has told you that you have high blood pressure, or hypertension. If you have this condition for a prolonged period, you may be more likely to have a heart attack or stroke. That's why treating high blood pressure is so important. And part of your pressure-lowering treatment plan may involve exercise.

Many recent studies have shown that regular aerobic exercise (workouts like brisk walking that use large muscles for an extended period) over several months may modestly lower blood pressure. According to a recent National Institutes of Health conference, aerobic exercise reduces resting (non-exercise) blood pressure in people who have hypertension by an average of 11 points off the top number and 9 points off the bottom number. That could be enough to lower high blood pressure to normal.

Before you dive into an exercise program, though, you need to talk to your doctor about your specific needs. Depending on how high your blood pressure is, he or she may want to supplement your exercise program with dietary changes, like less salt, or with drugs.

Because your body diverts blood to working muscles, exercise typically raises blood pressure. Although this effect is only temporary, if you have very high blood pressure, your doctor may want to lower it with drugs before you increase your physical activity. Exercise for people who have mild or moderate hypertension, however, is generally safe.

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Which Exercises Are Best?

Your doctor can help you decide what type of exercise might be best for you. But whatever your blood pressure, it's hard to go wrong with walking. Studies have shown that moderate aerobic exercise like walking may be even more effective in the long-term lowering of resting blood pressure than more intense aerobic exercise like running.

Start walking at whatever pace feels comfortable. As you slowly build fitness, gradually increase your pace and distance. Aim for at least 30 minutes per session 3 days a week--daily if possible--even if you have to work up to that level.

Depending on your fitness level and interests, you may want to try jogging, stationary or outdoor bicycling, swimming, rowing, using a stair-stepper, or low-impact aerobics. Or you can add some of these activities to your walking program for variety.

Conditioning your upper body can be a nice complement to aerobic exercise and may also help lower blood pressure. But the type of upper-body workout you do is crucial. It's generally safe to lift light weights for many repetitions (often called circuit training), but don't use heavy weights. Pumping heavy iron can raise blood pressure to dangerous levels. For the same reason, avoid pure isometric exercises, in which you push against a fixed object like a wall.

As long as you choose appropriate, moderate exercise like the types listed above, you and your doctor can tailor a safe, effective exercise program to your tastes and needs. The important thing is that you pick activities that you enjoy and that you stick with the program: It may take months for your blood pressure to decrease appreciably. In the meantime, though, you'll benefit from feeling more in shape and healthier.

Finally, ask your doctor how often you should schedule a check-up. Regular visits can help your doctor assess your health, and he or she may even decide to reduce or eliminate your blood-pressure medication.

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Out of the Pressure Cooker

Most people would prefer to control their hypertension without drugs--or minimize their need for medication--if possible. Though it's no cure-all, exercise can help you feel fit, healthy, and better about yourself while offering a good possibility of moderately lowering your blood pressure. And after all, who needs more pressure in life?

Often when you visit the doctor's office you have your blood pressure checked. You will be told that your blood pressure is, say, "120 over 80." What do those numbers mean?

Every beat of your heart pushes a wave of blood through your blood vessels, which raises the pressure in the arteries. This is called systolic blood pressure and is represented by the first number. The blood pressure between heartbeats (called diastolic pressure) is lower and is represented by the second number.

A reading of 120/80 mm Hg (or "120 over 80") is normal for a healthy adult. The abbreviation "mm Hg" is a unit of measure for pressure and is short for "millimeters of mercury." (Meteorologists use this same unit for measuring barometric [air] pressure.)

Keep in mind, though, that several factors can affect blood pressure, like how nervous you are. Your blood pressure can rise just from being in the doctor's office, so don't get too excited over one high reading. But if your blood pressure reading is consistently 140/90 or higher, you have high blood pressure--also called hypertension--a condition that afflicts nearly 62 million Americans. The higher the numbers are above 140/90, the more serious the hypertension (table A).

Source: Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, Bethesda, MD, National Heart, Lung, and Blood Institute, National High Blood Pressure Program, 1993

* Systolic blood pressure is the top, or first, number; diastolic is the bottom, or second, number.
** If your systolic and diastolic blood pressures are at different levels, the higher level is your blood pressure class.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

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