Exercising with Hypertension: What do you need to consider? – Lauren Turner AEP

Blood pressure (BP) is measured to determine the amount of pressure experienced in the main arteries of the heart. These measurements consist of a systolic reading, which refers to the pressure when the heart is at maximal contraction, and a diastolic reading, referring to the pressure when the heart is relaxed. Typically, a normal BP reading is 120/80 (systolic/diastolic) at rest. Hypertension is classified has an excessively high BP reading (>140/90). Patients with an increased BP are at an increased risk of heart failure and cardiovascular events including heart attacks and strokes.
When exercising, the demand to pump blood around the body increases. Thus, blood pressure increases as the heart must work harder to pump the oxygenated blood to muscles and organs involved in producing the movements. However, participating in an exercise program is beneficial in lowering BP. Whilst BP increases temporarily, physical adaptations occur to allow for improved blood flow through the arteries to keep up with the demand of the body. As demand increases the arteries dilate/expand to accommodate the increased volume of blood flow. Therefore, post exercise when blood flow demand has reduced, BP is lowered due to an increased artery diameter and decreased volume of blood in the arteries which ultimately reduces the pressure experienced in the main arteries of the heart.
The following are things to consider when participating in exercise with hypertension:

  1. Avoid Valsalva manoeuvre – Holding your breath when participating in exercise increases intra-abdominal pressure. Doing so further elevates BP. Lifting heavy weights might be something to avoid when initially starting an exercise routine as we are more susceptible to holding our breath under particularly strenuous loads.
  2. Overhead movements – When performing exercises that involve resistance-based overhead movements BP is further increased. This is due to the increased demand to pump blood to the muscles of the upper extremities against gravity.
  3. Monitor BP – Monitoring BP before and after exercise is important in the initial stages of participating in an exercise program as it provides information on how each individual’s BP responds to exercise. This can also be helpful in adjusting exercise intensity.
    As everyone is individual in the way their condition may present, it is important to consult your Exercise Physiologist before participating in an exercise program, once you have been given clearance from your GP or equivalent medical consultant.