Hypertension

Overview
One in Three people in the UK have high blood pressure2. For more facts and figures, click here
 
Effects on the exercise response
Studies have documented a consistent 10 to 20 mmHg reduction in systolic BP during the initial 1 to 3 hours following 30 to 45 min of moderate intensity dynamic exercise in individuals with hypertension1.
 
Effects of exercise training
Longitudinal studies show that endurance training may result in an average reducion of about 5 to 7 mmHg on both systolic and diastolic BP in persons with stage I or II hypertension1 (ie >140mmHg).
 
Management and medication
It is recommended that individuals make the following lifestyle modifications: lose weght, limit alcohol, complete >30min aerobic activity on most days, reduce salt intake, eat a diet rich in fruit and vegetables, and stop smoking1. There are a number of medications that are used to treat hypertension and some can have an effect on the response to exercise. Beta-blockers amongst others reduce the heart rate response to submax and maximal exercise1.
 
Exercise testing
Individuals with hypertension can be tested with standard eercise testing protocols, however, those with additional coronary risk factors, and males older than 45, and females older than 55 should perform a test with ECG monitoring before conducting a vigorous exercise program1.
 
Exercise Programming
Individuals with high BP (>180/110) should only begin exercising once undergoing drug therapy. Large, muscle aerobic activities are recommended aiming to complete >30min of physical activity per day on most days of the week. The intensity should be at 40-60& of HRpeak or RPE of 11-13/20. Individuals should aim to complete 700 kcal/week of actiity, building up to 2000 kcal/week over a number of months1. Resistance training can be used only to supplement aerobic training and should utilise lower resistance and higher repetitions (eg 1 set of 8-12 reps at 60-80% of 1RM)1
 
 
References
1.    American College of Sports Medicine (2009) ACSM's exercise management for persons with
        chronic diseases and disabilities (3rd Ed) Champaign, IL: Human Kinetics. (Ch38, p107-113)
 
Further Reading
  • American Heart Association (2004) Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women
  • Circulation.109: 672 - 693.
  • Ehrman, J., Gordon, P., Visich, P.S., Keteyianby, S. (2009) Clinical Exercise Physiology (2nd Ed). Champaign IL: Human Kinetics (see below)
  • Kelley, G.A. Kelley, K.A. and Tran, Z. (2001) Aerobic Exercise and Resting Blood Pressure: A Meta-Analytic Review of Randomized, Controlled Trials Prev Cardiol. 4(2): 73–80. [full text]

Ehrman et al (2009)

 
 
Suggested Web Sites
Blood Pressure Association. www.bpassoc.org.uk
American Heart Association. Click here
Comments