High blood pressure is one of the most common, chronic maladies that middle-aged and older people deal with as they age. Hypertension increases the risk of a variety of health problems, including stroke, cardiovascular disease, and kidney disease. Fortunately, it’s a condition that can usually be easily controlled, sometimes exclusively through lifestyle. In other cases, you might need medications.
If you have high blood pressure, your doctor may recommend exercise as a way to help normalize your blood pressure. In most cases, that’s good advice! But, here are a few things you should know about exercising with high blood pressure.
Certain Medications Used to Treat Hypertension Can Impact Exercise Performance
Did you know some blood pressure medications can negatively affect exercise endurance? One of the most common classes of anti-hypertensive medications that do this is beta-blockers. This group of medications reduces heart rate during aerobic exercise by 30 to 35%, making it harder to raise your heart rate. These medications also increase the sensation of how hard you’re working at a given exercise intensity. So, you feel like you’re working harder than you actually are. The good news is you can still get the health and fitness benefits of aerobic exercise, although you may not perform as well during a race, for example, if you’re taking a beta-blocker.
Do you use the maximal heart rate equation to determine your target heart rate and how hard you’re exerting yourself when you exercise? If you’re taking a beta-blocker, the equation is not as accurate, and you’ll have a hard time reaching your calculated target heart rate using this equation Instead, it’s better to use the Borg Rate of Perceived Exertion Scale to monitor the intensity of your workouts, as they don’t depend on heart rate to measure intensity.
Also, let your physician know, when they’re considering a blood pressure medication for you, that you exercise. There are a variety of classes of beta-blockers, each with a different impact on exercise tolerance. If your physician is aware that you work out, they can choose a beta-blocker that has less of a negative effect on exercise endurance or choose a different anti-hypertensive medication entirely.
Exercise May Lower Your High Blood Pressure
The best reason to exercise with high blood pressure is that doing so can help bring your blood pressure down. Studies show that aerobic exercise can lower systolic blood pressure, on average, 5 to 7 points. That’s substantial! If you have mild hypertension, this reduction may be enough to control your blood pressure without medication. But, whether or not you need medications is something you should discuss with your physician.
Don’t Get Up Quickly
If you exercise lying on a mat, don’t jump up off the mat too quickly. If you’re taking blood pressure medication, doing so can make you feel lightheaded or dizzy for a few seconds. This phenomenon, called postural hypotension, signals that blood isn’t reaching your brain quickly enough when you go from a sitting or lying position to a standing one. It’s a common problem when you’re taking blood pressure medications and your blood pressure is on the low side. It can also happen if you’re dehydrated. So, drink enough fluid before and during a workout, especially if you’re taking blood pressure medications. If you are getting lightheaded or dizzy when you get up quickly, monitor your blood pressure closely and let your physician know. They may need to adjust your medication or change it entirely.
Don’t Hold Your Breath
Do you have a tendency to hold your breath when you lift a heavy weight? It’s not a good practice for anyone, but it’s especially important to curb this habit if you have hypertension. Systolic blood pressure rises when you lift a heavy weight, and this effect is greatly magnified if you hold your breath while exerting yourself. The good news is studies show dynamic weight training workouts can lower blood pressure and reduce other risk factors for cardiovascular disease. But, make sure your blood pressure is adequately controlled before you grab barbells or dumbbells, and get your physician’s okay beforehand. They may recommend, depending on your current level of blood pressure control, that you use lighter weights and higher reps to avoid straining, at least until your blood pressure is under good control.
Check Your High Blood Pressure at Home
As most doctors will tell you, it’s best to monitor your blood pressure at home and keep a record of the readings. Getting your blood pressure checked every six months at an office visit doesn’t give a true picture of how well your pressures are controlled. Often, people have a higher blood pressure in a physician’s office due to stress. You can buy easy-to-use home monitors, but avoid using a finger or wrist device as they’re less accurate. Also, be aware that certain factors can give you a false reading. For example, did you know that a full bladder can raise your systolic blood pressure (the upper number) by as much as 15 points? Also, a blood pressure cuff that doesn’t fit properly, recent physical activity, caffeine, checking blood pressure over clothing, talking, and not supporting the arm where the pressure is being measured can cause the pressure to be inaccurate.
The Bottom Line
Staying physically active is important for heart health and for high blood pressure control. Research discussed in the American College of Sports Medicine journal shows that regular exercise can lower systolic blood pressure by 11 points and diastolic blood pressure by 8 points. That’s as much as many blood pressure medications! But, make sure you’re breathing properly and not holding your breath when you lift and that you know what impact your blood pressure medications can have on your exercise tolerance Check your pressures at home and document them, so your physician can adjust your medications to help you get optimal blood pressure control.
Curr Hypertens Rep. 2015; 17(11): 87.
Sports Med. 1985 Nov-Dec;2(6):389-412.
Journal of the American College of Cardiology. Volume 48, Issue 6, September 2006. DOI: 10.1016/j.jacc.2006.06.038.
WebMD.com. “Monitoring Blood Pressure at Home”
CMS Fitness Courses. “Resistance Training for Hypertension”