Low-Pressure Workouts for Hypertension

Alfred A. Bove, MD, with Carl Sherman

Series Editor: Nicholas A. DiNubile, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 4 - APRIL 98

Regular exercise is a central part of your program for controlling hypertension (high blood pressure). For most people who have hypertension, a few sessions of moderate physical activity each week will reduce blood pressure significantly and lower the risk of stroke and heart attack. If your blood pressure is just mildly elevated, exercise (along with a healthy diet and lifestyle) may be enough to bring it down to normal. If you need medication, exercise probably will make it more effective, and possibly allow you to take a lower dose.

Endurance Exercise

The best type of exercise for lowering blood pressure is aerobic activity that makes you breathe faster and gets your heart rate up. This can be brisk walking, jogging, swimming, or working out with machines like a treadmill or cross-country ski simulator. Choose one or more activities that will be convenient and enjoyable to do regularly.

For maximum benefit:

Exercise three or more times each week.
Take 5 minutes to warm up (with slow walking or stretching), do 25 to 30 minutes of exercise, and then spend 5 minutes cooling down with slower activity.
Exercise hard enough to bring your pulse rate up to a level that will strengthen your cardiovascular system. To compute a target heart rate, subtract your age from 220 and multiply by 0.7. (Example: If you are 55 years old, your target rate is 115.) If your target heart rate is difficult to achieve, use a value 10% to 20% lower and build up to the target. If you're taking blood pressure medication that can reduce heart rate (such as a beta-blocker), ask your doctor about your target heart rate.
Ease into it. If you haven't been exercising, start slowly: Walk for 20 minutes, for example, at a pace relaxed enough that you can converse. Gradually build up to longer, more strenuous workouts.

Strengthening Exercises

Your doctor may also suggest a weekly session of resistance exercise to increase your overall fitness and strengthen your upper body. This may mean using light weights (like dumbbells) or doing a series of exercises with Nautilus- or Cybex-type machines.

Exercise Safely

Moderate exercise poses very little risk for most people who have high blood pressure. If you are at high risk for heart disease (for example, if you have high cholesterol, are overweight, or have a family history of early heart attack), your doctor may recommend a stress test—monitoring your heart while you exercise under supervision—to find the level of exercise best for you.

To stay on the safe side, stop exercising and consult your doctor if you experience any of the following:

Unusual discomfort in your chest, jaw, or arm;
Dizziness; or
Extreme shortness of breath.

Make It Fun

Enjoy yourself. Make it easier to exercise consistently by choosing activities you enjoy in an environment you find pleasing (like a health club, outdoors, or while listening to music). Build regular sessions into your schedule. Exercise with friends and make it a social occasion.

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

Notes: ______________________________________________________________

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Dr Bove is chief of the cardiology section at the Temple University School of Medicine in Philadelphia. Mr Sherman is a freelance writer in New York City. Dr DiNubile is an orthopedic surgeon in private practice in Havertown, Pennsylvania, director of Sports Medicine and Wellness at the Crozer-Keystone Healthplex in Springfield, Pennsylvania, and a member of the editorial board of The Physician and Sportsmedicine.

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