High blood pressure, or hypertension, is among the most common diseases. In the United States alone, as many as 60 million people have elevated blood pressure. Unless complications develop, most people with hypertension have no symptoms. Yet, early treatment is imperative in order to prevent the disease from triggering a stroke, heart attack or other life-threatening problem.

Treatment for high blood pressure is individualized and may include weight loss, smoking cessation, reduced alcohol consumption, stress management and medication. Research shows that exercise is also very beneficial to hypertensive people, especially those who were previously sedentary.

Exercise Benefits
If you have hypertension, engaging in aerobic exercise three or more times per week provides multiple benefits. It serves as an effective form of treatment by helping to reduce stress, manage weight, and possibly lower blood pressure. Aside from those benefits, exercise offers the hypertensive individual the same gains that are available to the average person:

• improved cardiovascular system
• increased energy and stamina
• stronger immune system
• suppleness and flexibility
• stronger, more toned muscles
• stronger bones
• improved appearance
• enhanced psychological well-being

Starting an Exercise Program
Be sure to get a thorough physical examination by a physician before starting an exercise program. Hypertensive men over 40 years of age and hypertensive women over 50 should also have an exercise stress test with an electrocardiogram (ECG).

If your hypertension is accompanied by other medical conditions such as diabetes, obesity or elevated cholesterol, you should be treated for those problems first to lessen the risk of exercise-related complications.

If you are taking anti-hypertensive medications, your doctor can also explain what drug interactions to expect with exercise. For instance, vasodilators can reduce blood pressure more quickly than normal during the cool-down portion of your exercise session. Thus, a more gradual and lengthier cool-down is recommended. An exercise specialist can prescribe an exercise program that suits your needs and interests.

Exercise Guidelines
Endurance and Stamina Building

• Aerobic activities have the greatest potential of all the exercises to benefit hypertensive people. Make it the cornerstone of your exercise program.
• Appropriate cardiovascular exercises include walking, jogging, moderate-level aerobics classes, bicycling and swimming.
• Exercise at a moderate intensity of 50 to 70 percent of your maximum heart rate. Throughout the workout out you should be able to talk, and should not feel like you are pushing yourself beyond a comfortable state.
• Exercise three or more times per week.
• If you were previously sedentary, you may want to start with two or three 10-minute moderately-paced walks per day.
• Ideally, the duration of your exercise should be between 40 to 60 minutes. This length is probably most effective in reducing blood pressure.

Use the first five minutes of your cardiovascular workout as a warm-up, giving your body the necessary time it needs to get used to the activity. This is especially important since hypertensive individuals frequently have elevated resting blood pressure.

For the same reason, use the last five to ten minutes of your cardiovascular workout with a very gradual cool-down. Never stop suddenly.

Muscular/Skeletal Fitness

• Weight/resistance training is recommended as part of a comprehensive exercise program, but hypertensive individuals should give it a lower priority than aerobic activity.
• Perform exercises that target the major muscles of the body, such as legs, chest, back, arms and shoulders. These exercises include: weight training with light dumbbells, push-ups, and resistance exercises using surgical tubing or elastic bands.
• Slowly warm up the body prior to resistance training. For example, walk or perform light calisthenics for at least 10 minutes.
• Perform these exercises once or twice a week and gradually increase to three times per week. Be sure to train on nonconsecutive days.
• Perform all exercise in a slow and controlled manner to ensure the targeted muscles perform the work.
• Use weights that are light enough to complete 15 to 20 repetitions per set without straining.
• Gradually progress up to two sets per exercise. Only progress to heavier weights if your physician says it's safe for you to do so.

Flexibility, Balance and Mobility

• These exercises focus on minimizing stiffness, enhancing posture and helping gain confidence in balance and mobility, which reduces the risk of injury.
• Perform stretches for all the major muscles such as legs, chest, back and shoulders. These exercises can be performed daily or at least four times per week.
• Perform all exercises in a slow, controlled manner. Hold all of the stretches for 10 to 30 seconds without bouncing.
• Do stretches after the body has been warmed up, such as after a walk or shower.

Special Precautions

• Avoid lifting heavy weights that cause you to strain or press intensely.
• Avoid any exercise that places the feet above the head such as decline chest presses and incline sit-ups.
• Avoid weight-training exercises that bring the arms above the shoulders such as overhead shoulder presses.
• Be sure to breathe normally during the exercise; do not hold your breath or strain.
• Talk to your physician about the value of regularly monitoring your heart rate. It may not be useful if you are taking beta blockers, which lower heart rates.
• Beta blockers limit exercise tolerance and maximum oxygen intake. If you're taking these medications, avoid vigorous activity.
• High intensity exercise promotes excessive sweating and can increase the risk of potassium depletion and dehydration. People taking diuretics should be careful when exercising at that level of intensity.
• Stop exercising and consult your physician if you experience any of these symptoms: excess fatigue, chest pain, nausea, confusion or light-headedness.