Managing Hypertension With Exercise

Hypertension, or high blood pressure, is a medical condition in which the blood pressure (BP) in the arteries remains persistently high.

Blood pressure is the force exerted by the person’s blood against the walls of their blood vessels and determines how hard the heart has to work against the resistance of the blood vessels. A common health condition, Hypertension is also called ‘the silent killer’ since it may not necessarily produce symptoms for some time. However, uncontrolled or over the long term, it can become a major risk factor for several other health issues such as heart failure, coronary artery disease, aneurysm, stroke, dementia, kidney problems, damage to the eyes, among others.

Hypertension is one of the most important modifiable cardiovascular risk factors.

Exercise For Prevention & Management Of Hypertension

Medication may be needed to treat hypertension, but lifestyle adjustments will always form the bedrock of effective, preventive, and remedial actions. Some commonly known lifestyle recommendations include reducing salt intake, following a healthy heart diet, reducing smoking and alcohol consumption, managing body weight, and handling stress better. Along with these, another powerful and oft-neglected lifestyle practice is induction and practice of regular physical activity/exercise.

Epidemiological studies suggest that regular exercise can be beneficial for both prevention and treatment of hypertension in enabling weight loss, promoting functional health status, reducing all-cause mortality and risk of cardiovascular disease.

Regular exercise constitutes a key modifiable determinant of hypertension and is a powerful first line of defense in preventing, controlling, and treating it.

Recommendations For Exercise Prescription For People With Hypertension*

*Given that those with hypertension may experience effects of medications and can also present comorbidities, pre-participation screening (prior to exercising) for risk assessment, tailoring individual exercise prescriptions, and monitoring them can reduce barriers to activity participation and safely help enhance overall health.

While regularity is the key, some points need to be borne in mind for exercising with hypertension with respect to Frequency, Intensity, Time and Type (FITT Principle). The American College of Sports Medicine (ACSM) recommends the following:

Frequency:

• Perform (moderate intensity) aerobic exercises 5-7 days a week.
• Supplement with resistance exercise 2-3 days a week on non-consecutive days.
• Flexibility exercises 2-3 days a week.
• A higher frequency of aerobic exercise (nearly every day) is recommended than for those with normal BP (3-5 days a week) since even a single bout of exercise can lower BP by 5-7mm Hg (called post-exercise hypotension, which can last up to 22 hours after exercise). Exercise can, thus, act as a non-pharmacological BP-lowering measure.

Intensity: 

• Aerobic exercise should be moderate-intensity: 40-60% maximal aerobic capacity or VO2max; a level of effort 5 or 6 on a scale of 0 (no effort) to 10 (maximal effort); 50-70% of maximum heart rate; or intensity that causes noticeable increases in heart rate and breathing.
• Resistance exercise should be moderate-intensity: 50-70% of 1 RM (1 RM – the maximum amount of weight one can lift in a single repetition for a given exercise).
• Precaution: Heavy weight lifting should be avoided.
• Flexibility: stretch to the point of feeling slight discomfort, not pain.

Time: 

• Aerobic Exercise: 30-60 min per day, continuously or intermittent bouts of at least 10 min accumulating to at least 30 min per day
• Resistance Exercise: Each session should include at least 8-10 exercises, of at least 1 set of 8-12 repetitions per exercise.

Type: 

• Aerobic Exercise: Activities that use large muscle groups, are rhythmical, can be maintained continuously, and elicit an aerobic response are recommended as primary modalities, such as walking, cycling, swimming, jogging, water aerobics etc.
• Resistance Exercise: Exercises involving major muscle groups (legs, hips, abdomen, chest, back, arms, shoulders; Machine weights or free weight; should alternate upper and lower body workouts to allow for adequate rest between exercises;

Additional Points To Consider For Safe Exercising

• Get clearance from your doctor and consult a trained professional to guide with exercise prescription and proper technique.
• Breathe during exercises. Don’t hold your breath.
• Progress slowly with frequency and intensity of exercise, to avoid injury and increase compliance.
• Perform resistance exercises seated or standing to avoid feeling dizzy. Avoid sudden moves.
• Don’t clench fists while jogging or exercising.
• Always ‘listen to your body’. Pay attention to your heart rate response to exercise, esp. if on medication or changing medication dosage.

Exercise is a powerful tool to manage hypertension. Use it.

About Vani Pahwa

Vani B. Pahwa is Health & Wellness Evangelist, and Founder, Body In Motion, who specializes in Functional-Fitness, and Cancer Exercise & Rehabilitation. With almost 2 decades of experience, and certifications from leading internationally-accredited and globally-recognized fitness institutions, Vani is the leading Wellness Expert for Multinational Corporations and is a recognized Speaker and Coach. An Indian Classical Dancer, Vani encompasses her learnings from dance to everyday movement making “exercise and training for life, not just events.” To know more about Vani and her premium wellness services, visit https://www.bodyinmotion.in