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Hypertension (High Blood Pressure) and Exercise

Hypertension (High Blood Pressure) and Exercise

Hypertension (High Blood Pressure): Adopting a healthy lifestyle can have a positive effective in preventing and treating hypertension.  Here is what you can do…

Q) Ask Ray!  Ray, I have been diagnosed with hypertension.  My resting blood pressure is 145/92.  Besides just taking medications I want to start an exercise program.  What considerations should I have before I start?

Please read my Medical and Legal disclaimer.

A) I understand the basis behind the question and will discuss hypertension and how to prevent hypertension,  proper breathing during exercise and why it is important, and considerations when designing an exercise program for a hypertensive person.


Hypertension is a chronically elevated level of arterial blood pressure, in other words High Blood Pressure. This means that the heart of a person with hypertension has to work harder to pump blood through the body.  High blood pressure is considered anything over 140/90 mm/Hg and “normal” blood pressure is considered to be 120/80 mm/Hg.  These numbers are the reading of your systolic and diastolic blood pressure measurements. Systolic blood pressure is the pressure in your arteries when your heart pumps.  Diastolic blood pressure is the pressure in your arteries between heart beats.

Your blood pressure will fluctuate throughout the day depending on the time of day, the amount of physical activity you are engaged in, and the stress that you are under.  Hypertension will arise when your regulatory system for controlling blood pressure fails to function properly.  The result of this is that the small arteries in your body will constrict and stay constricted.  When this failure occurs, your heart has to pump harder to keep the blood flowing and drives your blood pressure up.  If this happens time after time over extended periods, chronic hypertension results.

Although there is not one specific identifiable cause of hypertension, there are many factors that can contribute to it.  Some of the know factors to hypertension are: smoking, alcohol consumption, age, heredity, race, gender, obesity, and a sedentary lifestyle; just to name a few.

What You Can do to Prevent Hypertension

As mentioned above, there is not one specific cause that is generally known to cause hypertension.  However, research has shown that adopting a healthy lifestyle can have a positive effective in preventing and treating hypertension.  Here are a few steps that you can take:

1) Adopt Healthy Eating Habits: This will have an emphasis on fruits, vegetables, low-fat dairy products, and foods that are low in saturated fat, total fat, and cholesterol.  Eating healthy will also help in maintain proper body weight.

2) Maintain Proper Body Weight: Being overweight increases your chances of developing high blood pressure.  If you already have developed hypertension, loosing weight has one of the greatest effects on reducing blood pressure.

3) Exercise Regularly: It does not take much effort to become physically active.  Starting a regular exercise program can be as easy as taking a short walk.

4) Limit Alcohol Consumption: Drinking alcohol raises blood pressure plus can cause damage to the liver, kidneys, brain, and heart.  Plus, if you are trying to lose weight, alcohol contains unwanted calories.

5) Quit Smoking: Smoking constricts blood vessels and make the heart pump harder to push blood through your body.  Smoking also speeds up the process of hardening of the arteries.

6) Reduce Salt and Sodium in Your Diet: Adopt a lower sodium diet to help reduce your blood pressure.  A lower sodium diet not only can help keep your blood pressure from rising, it may also help your blood pressure medications work better.

Proper Breathing Techniques and Considerations

Proper breathing is important in exercising, and if you are diagnosed as having hypertension; it is extremely important that you understand the effects that breathing has on your body.  Having strong respiratory muscles means that you will be able to take in and process more air per each breath. The result is that you will be able to supply more oxygen to your body to produce energy and help in your body’s recovery.  The stronger your respiratory muscles are the more effective your cardiovascular endurance.  Strengthening your respiratory muscles will prevent the onset of fatigue and help you recover faster. This is important because respiratory fatigue occurs before cardiovascular fatigue. Your breathing is directly related to your endurance as well as to your weight lifting exercises.

Proper Breathing While Lifting Weights

I am going to assume that most people with hypertension that are ready to being a fitness lifestyle will be new to exercising.  For these people it is recommended that while lifting weights that they inhale during the less strenuous phase and exhale during the strenuous phase.  I will use the example of a two arm bicep curl to explain the breathing technique.  While holding the weight with your arms lowered you will slowly raise the bar to your chest in a even and controlled fashion.  During this phase you will have taken a breath in before starting the lift. During the lifting phase you will be exhaling. Then while returning the weights back to the starting point you will inhale.

Technically the lifting of the weights is called the concentric contraction, and the lowering is call the eccentric contraction. During the concentric contraction phase the muscle will shorten as they overcome the resistance to the weight. While the weight is being lowered back to the starting position under constant tension, the muscle will lengthen and this is called the eccentric contraction.

Proper breathing during exercise is important because the internal pressure inside the chest and abdomen increases when you hold your breath on exertion.  If the increase is too great it can start to squeeze down on the blood vessels resulting in a shutting down of blood and oxygen to and from the heart.  When this happens, the result can be that you will pass out.  For someone that has hypertension the results can be serious.  For people with hypertension or other circulatory system or heart problems, they should avoid both heavy weight lifting and breath holding.

Considerations when Designing an Exercise Program for Hypertensive People

As it stands today, drug therapy is considered the most effect form of treating high blood pressure.  Along with drug therapy, regular exercise had been shown to play an important role as part of a treatment program for many people with high blood pressure.  However, there are some considerations that need to be addressed before anyone that has hypertension starts an exercise program.  These include the following:

1) Because vast majorities of the people that have hypertension are either obese and/or elderly, a non-weight bearing or low-impact aerobic activities (such as walking) should be emphasized.

2) The level of exercise intensity should be kept low.  The intensity range should be in the 50% to 75% Max Heart Rate range.

3) If the person is taking medications such as beta-blockers (which influence heart rate) then exercises should be conducted using the rate of perceived exertion to monitor exercise intensity.  The recommend range for these individuals is between 10 to 13 (light to somewhat hard).

4) The duration of exercise activity should be kept low in the beginning and gradually increase as adaptation occurs.  Generally a good starting range is between 20 to 30 minutes with the goal of progression to 30 to 60 minutes.  The longer exercise duration will help in promoting weight loss, which has been shown to reduce blood pressure.

5) Individuals with hypertension should exercise everyday, but realizing that this might not be a possible goal to reach; they should strive to exercise at least four times per week.  After a person with hypertension completes an aerobic workout there is a temporary reduction in blood pressure that can last for several hours.

6) Before starting any exercise, a hypertensive person should warm up properly.  They should have a longer than normal warm up session (longer than 5 minutes) to ensure that their body will be ready for the upcoming physical activities.  Also, an extended warm up session reduces the chance that a hypertensive person will experience a sudden rise in blood pressure.

7) Just as important as the warm up session, an extended cool down session is recommended.  After exercising hypertensive people are especially vulnerable to light headedness and fainting.  Cooling down properly (more than 5 minutes) helps prevent these from occurring.


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