Blood Pressure Uncuffed™ Volume 8: Can Exercise Improve My Hypertension?

April 29, 2024. By Sophie Cook

A diagnosis of hypertension usually comes along with various treatment options like lifestyle changes and medications. One of the most important ways to lower and control your blood pressure is by participating in regular physical activity. Did you know that regular physical activity can help:

Control hypertension
Manage a healthy weight
Strengthen your heart
Lower stress
Reduce risk factors for heart disease (1,5 )

How does exercise lower my blood pressure?

Being active keeps your heart and blood vessels in good shape so your heart doesn’t have to work as hard to pump blood to the rest of your body (7). Having a stronger heart puts less effort on your artery walls which can lower your BP. Regular physical activity will help you maintain a healthy weight, which is key to getting your blood pressure under control. In those who are overweight, losing just 5 lbs. has shown to help reduce BP (2). Some studies have shown a decrease in systolic BP from 3-6mmHg and 4-12mmHg in diastolic BP due to hypertensive subjects maintaining a regular exercise routine (2). Those with higher resting blood pressures will usually experience the greatest reductions in BP versus those with lower resting blood pressures (3). For example, someone with systolic readings in the 140’s could see a larger reduction in BP than someone with readings in the 120’s. Although exercising is an effective method to try and lower your BP, you may not see the effects right away. It can take anywhere from 1-3 months before you start to experience a change in your blood pressure (2). It’s important to note these benefits will only last if you continue to exercise.

The Right Amount

There are three main types of physical activity you should be engaging in each week. Those are aerobic, resistance, and flexibility exercises.

1. Aerobic Exercise

Aerobic exercises are long rhythmic activities that use your large muscle groups, some examples would be swimming, walking, and cycling. You should aim to include 30-60 minutes of aerobic exercise in your routine for 5-7 days per week. If you find that challenging, try to start with just 10-minute intervals spread throughout the day and progress as weeks go on. (4). During your aerobic exercise period, you should be working at a moderate intensity where you can see/feel noticeable differences in your heart & breathing rates (4). It’s important to make sure you don’t jump into things too quickly so make sure to warm up for at least 5 minutes before you start to increase your intensity. It’s important to note, it’s recommended that those with hypertension should engage in aerobic exercise at greater frequencies than those with normal blood pressure (3).

2. Resistance Exercise

Resistance training consist of activities like functional body weight exercises, using free weights, resistance bands, and resistance machines. These would be your typical squat, bicep curl, leg press, lunges, and chest press exercises (the list can go on and on). You should include resistance exercises in your routine 2-3 days per week. When doing resistance training, you should complete 2-4 sets of 8-12 repetitions of 8-10 different exercises during each session. You should be focusing on one of the major muscle groups each session, and include rest days in between so as not to work the same muscle groups back-to-back (3,4). For example, let’s say you wanted to work on your lower body. You would pick a handful of exercises (squats, leg press, lunges, glute bridges, hamstring curls) and complete 8-12 repetitions of each. You would then do that all over again (between 2-4 times) to complete multiple sets! This should total around 20 minutes in a moderate to vigorous intensity.

3. Flexibility Exercise

Flexibility exercises can be either static or dynamic. When warming up prior to a workout you should focus on dynamic stretching, and on static stretching post-exercise. You should be engaging in flexibility exercises at least 2-3 days per week. While doing these stretches you should hold each for 10-30 seconds and do 2-4 repetitions, which will total 60 seconds of stretching time per exercise and ~10 minutes for the entire flexibility session. The stretches should target a major muscle tendon that you were focusing on during your workout, and you should stretch to the point of feeling tightness or slight discomfort (3,4).

Is it Safe?

The health benefits associated with an increase in exercise for hypertensive patients far outweigh the risks (1). For most people it is perfectly safe to begin or increase exercise, but it is a good idea to ask your doctor if there are any safety considerations to be mindful of before starting a new exercise regimen (7). If you have other cardiovascular conditions or co-morbidities, then you need to meet with your provider before starting (1). The mechanism of exercising will cause a temporary rise in blood pressure, but should return to normal when you end. For those who have extremely high BP prior to exercise, it could be dangerous, and you should consult your provider immediately (7).

If you are ready to start, but haven’t been active in a while, take things slowly so you don’t overexert or injure yourself, and consult with your doctor or a trainer if necessary.

How to Start

First, you should find ways you enjoy being active and then build up the time and intensity levels. If you are new to exercise, you should try to break up 30 minutes and aim for three 10-minute sessions throughout the day then slowly increase the time until you can do one 30-minute session (2). You should start off simple by including more movement in your day. Set reminders to get up and walk around or get a drink of water, walk to your mailbox, walk your dog, or take the stairs instead of elevator. Just look for opportunities to walk throughout the day. If you need help motivating yourself and staying accountable, find ways to get active with others! Those who exercise with a buddy tend to stay with it longer than those who exercise on their own (6). But in the end, it’s all up to what works best for you and your life. Whether it’s a specific time of day, with a group, in a class setting, with friends/family, any movement is better than none!

Not only can regular exercise help reduce blood pressure and keep your heart healthy, but it can strengthen bones, improve balance, give more energy, lift your mood, improve cognitive function, and keeps the muscles and joints moving which can help you to be independent later in life (7).

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