Exercising with high blood pressure (hypertension)
Did you know that exercise can help to reduce your blood pressure? Or that exercising with hypertension can be safe if you apply a few important principles? If you have high blood pressure or have been told to get exercising because your blood pressure is too high, then read on to find out how to do it safely and effectively!
You’re not alone in having hypertension
A lot of people have been told by their GP/consultant that they have high blood pressure and may be looking for safe ways of reducing it. You may have been given medications to bring it down if it is high or been told to ‘lose weight and exercise more’. But what does that actually mean? And what sort of exercise is safe to do?
Unless you’ve been given specific information about exercise you may not know where to start. First of all, let’s look at ways to reduce your blood pressure which you can be doing along side taking medications. If you haven’t already downloaded it, you can get my ‘7 Ways to Reduce Your Blood Pressure Naturally’ Guide HERE which you may find useful. Then, let’s talk about what to do with regards to exercise when you have a blood pressure problem or are taking blood pressure medication.
What you need to know about exercising safely
Do you know what exercise to avoid? When to stop? And also what your upper limits are? All of these things I go through in someone’s first session with me. It’s important that I teach someone how to exercise safely so they can go off and exercise regularly by themselves, with confidence.
Exercise is a great way to help lower your blood pressure in combination with a healthy diet and your doctor’s treatment program. You may even be able to come off or reduce blood pressure medication. Remember to always consult your doctor before starting an exercise program and to listen to your body – especially when starting out. Ask them if they have advice specific to your health with regards to exercise or anything they suggest you avoid.
If you have high blood pressure, the best piece I can give someone is to listen to their body. How you feel during exercise should dictate the frequency and intensity of your workouts. While it is possible to lose weight while reducing your blood pressure, your top priority is to neutralize the threat of blood pressure before you push yourself toward more difficult exercise goals. To do this, consistency is essential. Frequency (the number of exercise sessions per week) is more important than intensity (how hard you are working), especially when you are starting out. AKA it’s better to be a turtle 5 days a week than a hare 1 day a week.
Know Your Numbers
By that I mean, know what your blood pressure is. Get a blood pressure monitor that is easy to use like this one. Take it regularly for the first few weeks so that you can see what your ‘normal’ is. Take it 2-3 times each time you do it and write down the lowest of the 3. For example, if you take it 3 times and your results are 145/90, 138/88, 142/92, the lowest of the 3 would be 138/88. Write it down along with the date and time of day. This is valuable information to take to your next doctor’s appointment. Taking your blood pressure at home can give a better reflection of your blood pressure, as being tested by a doctor or nurse can make you feel anxious and affect the result. It can also allow you to monitor your condition more easily.
What is a Normal Blood Pressure?
The current UK guidelines consider a blood pressure over 140/90 to be ‘high’.
As a general guide:
- normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
- high blood pressure is considered to be 140/90mmHg or higher
- low blood pressure is considered to be 90/60mmHg or lower
A blood pressure reading between 130/85mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.
Below I have set out some recommendations, both for aerobic exercise (cardio) and resistance exercise (weights). All of the exercise recommendations I’ve put below assume that your blood pressure is under control (whether through medication or diet) and is monitored by a doctor. These are general guidelines and are not specific to your needs. Please check with your doctor or health team as to specific guidelines for you. If you would like to book in for an exercise and heart health ‘MOT’ with me please get in touch HERE.
Aerobic Exercise Recommendations (cardio)
- If you are new to exercise or haven’t exercised in awhile, start slowly and increase the time and intensity of your workout as you get stronger. A good starting point is 30 minutes of cardiovascular activity, 3 days per week. Examples include walking, swimming and biking.
- If 30 minutes is too much, start with 10-20 minutes and increase from there. Eventually, the goal is to work up to 45-60 minutes, 5 days per week. This doesn’t have to be at a gym. It can be a walk, cycle, dance class, etc.
- It is important to warm up before and cool down after each exercise session (10 minute warm up, 10 minute cool down). An easy way to do this is to start at home, marching on the spot or using a stair to step up and down, gradually increasing the pace.
- You can work out a guide to what your heart rate should be using the Karvonen formula calculator HERE. Remember this is a guide only and does not take into account if you are on a beta blocker or how you FEEL at certain heart rates so please use this in combination with RPE. Get in touch to learn more about your heart rate and exercise.
- Monitor your exercise intensity by using the RPE scale (Rate of Perceived Exertion). The scale goes from 1-10. Imagine a 1 is sitting on the couch and a 10 is an all out sprint. You ideally need to perform a warm up to bring you gradually up to a 5/10 and then work at a 5-6/10 for 30 minutes. A 5-6 should feel like you are exercising yet you can comfortably hold a conversation and can keep going for a lot longer. This will ensure a safe and comfortable level of exercise.
- The best activities to do are the ones you enjoy and will stick with. Join a walking/ramblers club or meet a friend for coffee and go for a brisk walk first. You are more likely to do exercise if you do it with a friend or partner.
- Avoid suddenly stopping. Always perform a cool down for at least 5-10 minutes where you bring your heart rate down gradually.
Strength Training and Weights
Many people with hypertension avoid strength training because they are afraid that it will increase their blood pressure. But research shows that strength training can actually help to reduce blood pressure (Journal of Hypertension 2005, Vol 23 No 2).
If you have high blood pressure, you should avoid strenuous strength-related activities, in particular anything that requires you to hold your breath. Activities of this type, including isometric strength training (where you hold a weight in one position for a longer period), may cause excessively high blood pressure responses and are potentially dangerous for many people with hypertension.
Safe resistance training tips:
- Lift lighter weights for a higher number of reps. (A good weight is one that you can lift for 12-15 repetitions in good form without holding your breath). When you get to the end of the set you should have at least 1-2 left ‘in the tank’.
- Move continuously throughout each exercise (to avoid an isometric hold).
- Breathe throughout each exercise (exhaling as you exert effort or lift the weight and inhaling as you return to the starting position).
- Avoid lifting heavy weights above your head. This can increase your blood pressure.
- DO NOT lifting maximum weights, performing isometric contractions, or hold your breath. (These practices result in excessive blood pressure responses and should be avoided)
- Avoid weight training (and other exercise) when your blood pressure is above 180/100. The actual guidelines say over 200/110 but I’d be calling an ambulance if it was that high! If you notice your blood pressure is a lot higher than usual it’s worth getting things checked with your GP asap)
- Avoid weights when you are unwell, have a fever, or are feeling very tired.
- Avoid getting up from the floor, bench or weights machine quickly. If you take blood pressure medication, it may take your body longer to adjust from changing positions. So give yourself more time to get up and stand for a little bit longer before moving onto your next exercise.
It is recommended that people with hypertension follow an exercise programme with a combination of cardio and resistance. You can separate these into different days or perform on the same day. If doing resistance and cardio on the same day it is best to perform your cardio first.
Other Exercise Considerations
Some medications (such as beta-blockers) lower both your resting heart rate and your heart rate when working out. Therefore, when exercising, your heart rate will NOT reflect how hard you are actually working. Therefore it is important to use the RPE scale to measure how hard you are working. Taking a beta blocker can reduce your maximum heart rate by 10-20 beats per minute so you’ll need to take that into consideration.
Exercise is a great way to help lower your blood pressure in combination with a healthy diet and your doctor’s treatment program. Remember to always consult your doctor before starting an exercise program and to listen to your body – especially when starting out.
Get in touch if you would like to know more about exercises specific to your needs and we can talk about a personalized exercise programme for you. If you would like to book in for an exercise and heart health ‘MOT’ with me please get in touch HERE.
Until next time, have a great week!
Cardiac Nurse Specialist & Exercise Coach