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Hypertension and exercise

  written by Dr. Basudev Tewari |     May 7, 2018

High BP! Systolic>140 and Diastolic>90 mm of Hg and doctor tells you have HYPERTENSION and BOOM, your life changes. Let us talk about hypertension and exercise. Lots of people around have got hypertension. This is an extremely common genetic as well as lifestyle disease and its incidence is on the rise. There is a psychological and stress factor too.

Welcome to an extremely common but silently progressing disease. It won’t kill you but destroy you eventually over years, if you ignore it.

This is an era when hypertension is on the rise. It commonly runs in families called essential hypertension. As the flexibility and elasticity of your artery wall is damaged, you are welcome to the world of hypertension.

It has lots of inherent risks starting from cardiovascular disease, kidney failure, atherosclerosis, strokes etc. It is a lifestyle disease which gets activated by sedentary and unhealthy lifestyle.

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So, you have hypertension? Or maybe hypertension runs in your family. In that case, many questions may pop up in your mind as your doctor prescribes you medicines and diet restrictions and advises you to exercise. Salt restriction is recommended too.

Did these questions come up in your mind:

Should you exercise?

How much, how often?

Any restriction or warning?

Any interaction with medications?

How will it help, by the way?

Questions may be endless…

Even if you don’t have hypertension but have someone in your family, you should be on guard too. Please read on…

Let me answer the questions one by one…

Q. Should I exercise at all?

Ans. Yes definitely you should. Besides medications, proper diet and lifestyle modifications exercise can have a huge role in controlling hypertension. Exercise lifelong have proved to reduce mortality by 10% besides saving you from lots of complications of high blood pressure. You will have simply a much better life ahead. If you add proper exercise with medications.

Q. Is there any condition where exercise should be restricted or not be done altogether?

Ans. If your BP is more than 160/100 you should avoid weight training or consult your doctor for clearance.

If you have resting blood pressure of more than 180/110 mmHg, you should not exercise. Also, if your BP increases above 260/120 mmHg during aerobic exercise, you should not too.

Do you have the above conditions? Slow down, correct them first and then head towards the gym, that is the best option for you.

Q. Should any specific types of exercises be restricted or avoided?

Ans. Try to avoid following:

1. Isometrics (where muscle tension is generated without movement at the joint),.

2. Tight gripping of dumbbells,

3. Overhead raising of weights or where head is below level of hands,

4 Valsalva i.e. forced expiratory effort against closed glottis,

5. Breath holding during lifting weights (always expire during lifting and inspire during eccentric phase),

6. Any kind of straining, high intensity cardio (>90% of you Maximum heart rate) without clearance from your physician,

7. Heavy weight training more than 90% of your 1 Rep max without clearance from physician.

8. Do not keep muscles contracted for a long time.

All of the above causes ‘pressor response’ which spikes the blood pressure (mainly in the diastolic part), significantly. So try to avoid them as much as you can.

Q. How often should I exercise and which types to choose?

Ans. Do moderate intensity cardio or aerobic exercises for at least 150 minutes (2 hours and 30 minutes) weekly. You can perform it by doing 30 minutes of aerobic exercises at least 5 days each week. Even if you do 20 minutes of them daily that is way better than sedentary lifestyle. Simple ones like brisk walking, cycling, jogging, swimming, skipping etc. will do.

Also do resistance training on two or more days a week and try to work all major muscles groups (legs, hips, back, abdomen, chest, shoulder and arms)

Flexibility exercises like stretching, yoga, Tai chi, pilates etc. can be done daily.

Q. How hard (or rather intense) should I exercise?

Ans. You should to do aerobics hard enough to break a sweat, but still able to talk (but cannot sing, anyway) or rather 40 to 60 % of your Maximum heart rate.

For strength training choose weight so that you can lift it for 8 to 12 reps before fatigue. But try not to lift weights more 85-90% of your 1 rep max.

Q. Is there any precaution for exercising to be taken when a medication is taken for hypertension?

Ans. If you are taking diuretic types of drugs, water intake should be increased both during exercise and rest and keep an eye on proper sodium/potassium intake.

For Beta blocker group of drugs like Atenolol, Metoprolol, Propranolol etc. maximum heart rate response is blunted. So the target heart rate has to be revised and lower than your original value. Also Beta blockers and ACE inhibitors cause some amount of dizziness and fatigue which can impact intensity.

Other medications like calcium channel blockers, and alpha blockers and central alpha agonists have negligible effect on exercise. But still a consultation with your doctor is preferable if you take any antihypertensive drug.

Q. Any other special precaution should I take during exercise?

Ans. Yes there are a few for your own safety, like:

  • Measure your blood pressure before and after exercise, at least on first day and later as exercise programme changes

  • Few of your medicines like calcium channel blockers, vasodilators and alpha blockers can cause dizziness and weakness on standing after exercise due to peripheral blood pooling. Hence ‘cool down’ after exercise and stand up slowly from lying/sitting position during exercise.

  • Caffeine is capable of spiking blood pressure. So better skip it few hours before workout.

  • Gradually warm up before exercise at will allow body to adjust to the blood pressure by raising it slowly.

  • Progression during aerobic and anaerobic exercises should be slower than normal. For aerobics try to increase time before intensity. For weights keep the incremental weights smaller than normal

 

P.S. – For any other queries, feel free to contact me. I shall try my best to help you out. For even better help, welcome to the India’s first health and fitness facebook group by doctors, getindiafit

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3 responses to “Hypertension and exercise”

  1. P k g mahapatra says:

    New recommendations from AHA tells > 130/80 as hypertension

    • Dr. Basudev Tewari says:

      Thanks for the updates. But for exercise purposes, the older recommendation holds good.

  2. […] Hypertension and obesity control – Other Comorbid conditions where exercise can help a lot. Read my article on hypertension and exercise. https://easyfitnessidea.com/hypertension-and-exercise/ […]

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