Q. Is it safe to exercise if I have high blood pressure?
A. Yes! In fact, along with eating more plants and lowering sodium intake, getting regular exercise is an important lifestyle modification you should adopt if you have hypertension.
A person is considered to have pre-hypertension if resting blood pressure is 120-139/ 80-89, Stage 1 hypertension if blood pressure falls within the 140-159/90-99 range, and Stage 2 hypertension if numbers are 160 or greater/100 or greater. A person diagnosed with Stage 1 or Stage 2 hypertension is generally prescribed antihyperintensive medications, but increased physical activity is encouraged for people at all levels of hypertension.
What may seem odd is that blood pressure actually increases slightly during exercise. But, this acute effect of exercise is a normal response. As the body starts to move more vigorously, muscles and cells in the body require more oxygen. So the heart rate and breathing rate speed up to suck in more oxygen and distribute it throughout the body. Although heart rate can double, blood pressure typically only rises a bit. And it's only the top number (systolic blood pressure) that tends to increase in response to physical activity. Systolic pressure reflects the force of the blood being pushed out into the arteries by the heart. But the rise is typically only slight because a fit person develops an improved capacity for the blood-vessel walls to expand to accommodate greater, faster and stronger blood flow. Conversely, after exercise, blood pressure can lower. This is known as post-exercise hypotension.
There is some concern that people with hypertension may not have the same compliance in their arterial walls and so may be at higher risk if blood pressure spikes during exercise. So, if you have high blood pressure, you should always get the OK from your doctor to exercise. And you may want to build up to higher intensities gradually, although it's unclear whether intensities of exercise play a role in blood-pressure changes.
During exercise, the bottom number (diastolic blood pressure) may stay the same or slightly decrease. If the diastolic number increases, this is a red flag that the exercise should be stopped, according to guidelines from the American College of Sports Medicine.
People who are taking blood-pressure medications such as vasodilators, calcium channel blockers, ACE inhibitors, beta blockers and similar meds may have a diminished blood-pressure response to exercise. Of course, most people who exercise do not check their blood pressure throughout the session. Blood pressure is typically only measured during clinical exercise testing. That's why you need clearance from your doctor before you proceed.
But if you do exercise, and stick to it, the long-term effects on your blood pressure and your health are promising. Although all people show lower blood pressure as a result of regular workouts, people with hypertension show greater reductions. The 2008 Physical Activity Guidelines for Americans report that a 5 percent drop in both systolic and diastolic pressure can be seen, with an average drop of 7 mmHg in the systolic number and around 5 mmHg in the diastolic number. That may not seem like a drastic drop, but clinically it's considered very powerful because even a 2 mmHg decrease in systolic blood pressure can significantly lower the risk of stroke, as well as the death rates from heart disease, stroke and all causes of death, according to a 2002 report from the National Institutes of Health (NIH).
Most of the research that shows improvements in blood pressure has shown that these benefits come from cardio workouts, or aerobic exercise. Resistance training, or weight training, used to be avoided for fear that gripping and hoisting a heavy weight would be detrimental to blood pressure, but recent research has shown that weight training can also lower blood pressure over time, although aerobic exercise is considered to be more powerful. A 2011 metanalysis in the journal Hypertension evaluated 28 randomized controlled trials and found that resistance training lowered blood pressure in those with normal blood pressure or pre-hypertension, but not significantly in people with high blood pressure.
If you do have high blood pressure, here are five things you should know:
1. If you are taking high-blood-pressure medication, be on the alert for blood pressure that drops too low once you've stopped exercise. To minimize this, slow down from an exercise session gradually.
2. If your blood pressure is severe or uncontrolled, only start exercising after you've started medications and been evaluated by your doctor.
3. Avoid high-intensity or extremely vigorous exercise unless you have been given the all-clear by your physician. That's not to say that you can't run, for example, but you should run at a pace and intensity that you are fit enough to handle. Start slow and easy and work up to higher intensities gradually. Ditto with weightlifting: Keep you ego in check and avoid straining to lift more weight than you are capable of lifting. Start light and work up to heavier loads slowly.
4. Isometric, or 'static,' exercise involves holding muscles in a contracted state for a period of time. Some yoga positions require this, as do some exercises or fitness tools that require you to squeeze your muscles or hands. The isometric contraction can result in a spike in blood pressure, so it is generally recommended to avoid this kind of exercise.
5. Be aware that some yoga positions that involve hyperextension or rotation of the neck may increase your risk of a stroke, according to a 2001 study in the New England Journal of Medicine. These include inversions such as head and shoulder stands and even the triangle and plow poses.
By Martica Heaner, M.A., M.Ed., for MSN Health & Fitness
A. Yes! In fact, along with eating more plants and lowering sodium intake, getting regular exercise is an important lifestyle modification you should adopt if you have hypertension.
A person is considered to have pre-hypertension if resting blood pressure is 120-139/ 80-89, Stage 1 hypertension if blood pressure falls within the 140-159/90-99 range, and Stage 2 hypertension if numbers are 160 or greater/100 or greater. A person diagnosed with Stage 1 or Stage 2 hypertension is generally prescribed antihyperintensive medications, but increased physical activity is encouraged for people at all levels of hypertension.
What may seem odd is that blood pressure actually increases slightly during exercise. But, this acute effect of exercise is a normal response. As the body starts to move more vigorously, muscles and cells in the body require more oxygen. So the heart rate and breathing rate speed up to suck in more oxygen and distribute it throughout the body. Although heart rate can double, blood pressure typically only rises a bit. And it's only the top number (systolic blood pressure) that tends to increase in response to physical activity. Systolic pressure reflects the force of the blood being pushed out into the arteries by the heart. But the rise is typically only slight because a fit person develops an improved capacity for the blood-vessel walls to expand to accommodate greater, faster and stronger blood flow. Conversely, after exercise, blood pressure can lower. This is known as post-exercise hypotension.
There is some concern that people with hypertension may not have the same compliance in their arterial walls and so may be at higher risk if blood pressure spikes during exercise. So, if you have high blood pressure, you should always get the OK from your doctor to exercise. And you may want to build up to higher intensities gradually, although it's unclear whether intensities of exercise play a role in blood-pressure changes.
During exercise, the bottom number (diastolic blood pressure) may stay the same or slightly decrease. If the diastolic number increases, this is a red flag that the exercise should be stopped, according to guidelines from the American College of Sports Medicine.
People who are taking blood-pressure medications such as vasodilators, calcium channel blockers, ACE inhibitors, beta blockers and similar meds may have a diminished blood-pressure response to exercise. Of course, most people who exercise do not check their blood pressure throughout the session. Blood pressure is typically only measured during clinical exercise testing. That's why you need clearance from your doctor before you proceed.
But if you do exercise, and stick to it, the long-term effects on your blood pressure and your health are promising. Although all people show lower blood pressure as a result of regular workouts, people with hypertension show greater reductions. The 2008 Physical Activity Guidelines for Americans report that a 5 percent drop in both systolic and diastolic pressure can be seen, with an average drop of 7 mmHg in the systolic number and around 5 mmHg in the diastolic number. That may not seem like a drastic drop, but clinically it's considered very powerful because even a 2 mmHg decrease in systolic blood pressure can significantly lower the risk of stroke, as well as the death rates from heart disease, stroke and all causes of death, according to a 2002 report from the National Institutes of Health (NIH).
Most of the research that shows improvements in blood pressure has shown that these benefits come from cardio workouts, or aerobic exercise. Resistance training, or weight training, used to be avoided for fear that gripping and hoisting a heavy weight would be detrimental to blood pressure, but recent research has shown that weight training can also lower blood pressure over time, although aerobic exercise is considered to be more powerful. A 2011 metanalysis in the journal Hypertension evaluated 28 randomized controlled trials and found that resistance training lowered blood pressure in those with normal blood pressure or pre-hypertension, but not significantly in people with high blood pressure.
If you do have high blood pressure, here are five things you should know:
1. If you are taking high-blood-pressure medication, be on the alert for blood pressure that drops too low once you've stopped exercise. To minimize this, slow down from an exercise session gradually.
2. If your blood pressure is severe or uncontrolled, only start exercising after you've started medications and been evaluated by your doctor.
3. Avoid high-intensity or extremely vigorous exercise unless you have been given the all-clear by your physician. That's not to say that you can't run, for example, but you should run at a pace and intensity that you are fit enough to handle. Start slow and easy and work up to higher intensities gradually. Ditto with weightlifting: Keep you ego in check and avoid straining to lift more weight than you are capable of lifting. Start light and work up to heavier loads slowly.
4. Isometric, or 'static,' exercise involves holding muscles in a contracted state for a period of time. Some yoga positions require this, as do some exercises or fitness tools that require you to squeeze your muscles or hands. The isometric contraction can result in a spike in blood pressure, so it is generally recommended to avoid this kind of exercise.
5. Be aware that some yoga positions that involve hyperextension or rotation of the neck may increase your risk of a stroke, according to a 2001 study in the New England Journal of Medicine. These include inversions such as head and shoulder stands and even the triangle and plow poses.
By Martica Heaner, M.A., M.Ed., for MSN Health & Fitness
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