How exercise helps to reduce blood pressure

Every year, May 17 is dedicated to World Hypertension Day (WHD). However, as a result of the rapidly growing burden of disease associated with the global increase in hypertension, the International Society of Hypertension (ISH) and the World Hypertension League (WHL) have designated the entire month of May as May Measurement Month (MMM). The resource person for today’s article is Dr. Sujeewa Weerasinghe, the National Organiser of the Chartered Society of Physiotherapists.  

High blood pressure (hypertension) is the major risk factor for cardiovascular disease. Hence, in 2002, it was named ‘the number one killer’ by the World Health Organization (WHO) in The World Health Report.

Risk of stroke is four times greater and the risk of myocardial infarction (a heart attack) two times greater if you have high compared with normal blood pressure. This risk increases the higher the level of a person’s blood pressure. According to Dr. Margaret Chan, Director-General World Health Organization Hypertension is a silent, invisible killer that rarely causes symptoms. Increasing public awareness is key, as is access to early detection. Raised blood pressure is a serious warning sign that significant lifestyle changes are urgently needed.

People need to know why raised blood pressure is dangerous, and how to take steps to control it. They need to know that raised blood pressure adds to the risk factors that create diabetes. These two often appear together. To raise this kind of awareness, countries need systems and services in place to promote universal health coverage and support healthy lifestyles: eating a balanced diet, reducing salt intake, avoiding harmful use of alcohol, getting regular exercise and shunning tobacco. Access to good quality medicines, which are effective and inexpensive, is also vital, particularly at the primary care level. As with other no communicable diseases, awareness aids early detection while self-care helps ensure regular intake of medication, healthy behaviors and better control of the condition.

High-income countries have begun to reduce hypertension in their populations through strong public health policies such as reduction of salt in processed food and widely available diagnosis and treatment that tackle hypertension and other risk factors together. Many can point to examples of joint action – across sectors – that is effectively addressing risk factors for raised blood pressure.

In contrast, many developing countries are seeing growing numbers of people who due to undiagnosed and uncontrolled risk factors such as hypertension. Blood is carried from the heart to all parts of the body in blood vessels. Each time the heart beats, it pumps blood into the vessels.

Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart.

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure.

The higher the pressure in blood vessels the harder the heart has to work in order to pump blood. If left uncontrolled, hypertension can lead to a heart attack, an enlargement of the heart and eventually heart failure. Blood vessels may develop bulges (aneurysms) andweak spots due to high pressure, making them more likely to clog and burst. The pressure in the blood vessels can also cause blood to leak out into the brain. This can cause a stroke. Hypertension canalso lead to kidney failure, blindness, rupture of blood vessels andyour risk of high blood pressure (hypertension) increases with age, but getting some exercise can make a big difference. And if your blood pressure is already high, exercise can help you control it. Don’t think you’ve got to run a marathon or join a gym. Instead, start slow and work more physical activity into your daily routine.

How are high blood pressure and exercise connected? Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure.

Becoming more active can lower your systolic blood pressure — the top number in a blood pressure reading — by an average of 4 to 9 millimeters of mercury (mm Hg). That’s as good as some blood pressure medications. For some people, getting some exercise is enough to reduce the need for blood pressure medication.

If your blood pressure is at a desirable level — less than 120/80 mm Hg — exercise can help prevent it from rising as you age. Regular exercise also helps you maintain a healthy weight — another important way to control blood pressure.

But to keep your blood pressure low, you need to keep exercising on a regular basis. It takes about one to three months for regular exercise to have an impact on your blood pressure. The benefits last only as long as you continue to exercise.

How much exercise do you need?
Aerobic activity can be an effective way to control high blood pressure. But flexibility and strengthening exercises such as lifting weights are also important parts of an overall fitness plan. You don’t need to spend hours in the gym every day to benefit from aerobic activity. Simply adding moderate physical activities to your daily routine will help.

• Any physical activity that increases your heart and breathing rates is considered aerobic activity, including:
• Household chores, such as mowing the lawn, raking leaves, gardening or scrubbing the floor
• Active sports, such as basketball or tennis, Climbing stairs
• Walking, Jogging, Bicycling, Swimming and Dancing.

The WHO recommends getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. Aim for at least 30 minutes of aerobic activity most days of the week.

If you can’t set aside that much time at once, remember that shorter bursts of activity count, too. You can break up your workout into three 10-minute sessions of aerobic exercise and get the same benefit as one 30-minute session.

Also, if you sit for several hours a day, try to reduce the amount of time you spend sitting. Research has found that too much sedentary time can contribute to many health conditions. Aim for five to 10 minutes of low-intensity physical activity — such as getting up to get a drink of water or going on a short walk — each hour. Consider setting a reminder in your email calendar or on your smartphone.

Weight training and high blood pressure
Weight training can cause a temporary increase in blood pressure during exercise. This increase can be dramatic, depending on how much weight you lift.

But weightlifting can also have long-term benefits to blood pressure that outweigh the risk of a temporary spike for most people. And it can improve other aspects of cardiovascular health that can help to reduce overall cardiovascular risk. The Department of Health and Human Services recommends incorporating strength training exercises of all the major muscle groups into a fitness routine at least two times a week.

If you have high blood pressure and you’d like to include weight training in your fitness programme, remember:

Learn and use proper form. Using proper form and technique when weight training reduces the risk of injury.

Don’t hold your breath. Holding your breath during exertion can cause dangerous spikes in blood pressure. Instead, breathe easily and continuously during each exercise.

Lift lighter weights more times. Heavier weights require more strain, which can cause a greater increase in blood pressure. You can challenge your muscles with lighter weights by increasing the number of repetitions you do.

Listen to your body. Stop your activity right away if you become severely out of breath or dizzy, or if you experience chest pain or pressure.

If you have high blood pressure, get your doctor’s OK before adding weight training exercises to your fitness routine.

When you need your doctor’s permission 
Sometimes it’s best to check with your doctor before you jump into an exercise program, especially if:

• You’re a man older than age 45 or a woman older than age 55.
• You smoke or quit smoking in the past six months.
• You’re overweight or obese.
• You have a chronic health condition, such as diabetes, cardiovascular disease or lung disease.
• You have high cholesterol or high blood pressure.
• You’ve had a heart attack.
• You have a family history of heart-related problems before age 55 in men and age 65 in women.
• You feel pain or discomfort in your chest, jaw, neck or arms 
• during activity.
• You become dizzy with exertion.
• You’re unsure if you’re in good health or you haven’t been exercising regularly.

If you take any medication regularly, ask your doctor if exercising will make it work differently or change its side effects — or if your medication will affect the way your body reacts to exercise.

Keep it safe
To reduce the risk of injury while exercising, start slowly. Remember to warm up before you exercise and cool down afterward. Build up the intensity of your workouts gradually.
Stop exercising and seek immediate medical care if you experience any warning signs during exercise, including

• Chest, neck, jaw or arm pain or tightness
• Dizziness or faintness
• Severe shortness of breath
• An irregular heartbeat
• Monitor your progress
• The only way to detect high blood pressure is to keep track of your blood pressure readings. Have your blood pressure checked at each doctor’s visit, or use a home blood pressure monitor.

If you already have high blood pressure, home monitoring can let you know if your fitness routine is helping to lower your blood pressure, and may make it so you don’t need to visit your doctor to have your blood pressure checked as often. Home blood pressure monitoring isn’t a substitute for visits to your doctor, and home blood pressure monitors may have some limitations.

If you decide to monitor your blood pressure at home, you’ll get the most accurate readings if you check your blood pressure before you exercise.