New Guidelines for Exercise and Hypertension

Moderate Exercise Recommended to Prevent and Control High Blood Pressure

Medically Reviewed by Brunilda Nazario, MD on March 09, 2004

March 9, 2004 -- Getting at least 30 minutes a day of exercise not only helps prevent heart problems, but it should also be a part of the prescription for treating people with high blood pressure, according to a new report.

Revised guidelines on exercise and hypertension released today by the American College of Sports Medicine indicate that exercise should be a cornerstone of therapy for the prevention, treatment, and control of high blood pressure, and getting the recommended daily dose may not necessarily require working up a sweat.

"Moderate-intensity exercise has been scientifically documented to effectively lower blood pressure in people, perhaps more so than vigorous-intensity exercise," says Linda Pescatello, PhD, who was co-chairwoman of the panel that compiled the report. Moderate-intensity exercise includes walking, biking, and other activities that moderately raise the heart rate.

Pescatello says that news is especially good for people with hypertension who are more susceptible to potential health risks from more vigorous exercise, such as running.

"The fact that the evidence shows that moderate intensity exercise is preferred actually optimizes the blood pressure-lowering capacity of exercise for these people while minimizing risk," says Pescatello, who is also associate professor and director of the Center for Health Promotion at the University of Connecticut.

The complete report appears in the March issue of Medicine & Science in Sports & Exercise.

Daily Exercise Recommended

Researchers say the guidelines replace ones issued in 1993 and contain a greater emphasis on consistent, moderate-intensity physical activity and resistance exercise (such as weight training) as a vital part of treating and preventing high blood pressure. Previous recommendations called for more vigorous exercise on three to five days of the week.

The new guidelines call for 30 minutes of moderate-intensity physical activity (primarily aerobic exercise, which helps get heart rates to 70%-85% of an individual's maximal heart rate, or endurance exercise supplemented by resistance exercise) on most, preferably all days of the week for people with hypertension. The 30 minutes can be at once or accumulated during the day, such as in three 10-minute walks. These recommendations are in line with national physical activity guidelines for healthy adults issued by the CDC.

Here's how to calculate 70% and 85% of your maximal heart rate, in heartbeats per minute:

  1. Maximal heart rate = 220 - [your age]
  2. 70% of Maximal heart rate = 0.70 x [max HR]
  3. 85% of Maximal heart rate = 0.85 x [max HR]

Researchers say exercise programs that involve endurance activities, such as walking, jogging, running, or cycling, coupled with resistance training can help prevent the development of hypertension and lower blood pressure in adults.

But even a single exercise session provides an immediate reduction in blood pressure that can last for up to 22 hours.

"The people who get the most benefit out of these exercise programs nationwide increasingly are the people who are doing nothing and start to do something. It's not the guy who to goes from 30 miles a week to 35," says researcher Barry Franklin, PhD, director of the cardiac rehabilitation and stress laboratory at William Beaumont Hospital in Royal Oak, Mich. "It's the low-fitness, inactive, hypertensive individual who starts a program -- even of moderate intensity -- who stands to gain the greatest benefit."

Walk, Don't Run to the Doctor First

Researchers say people with high blood pressure can safely participate in an exercise program or competitive sports, but they should be evaluated, treated, and monitored closely by their health care professional.

The report also outlines special exercise recommendations for people with hypertension including:

  • Beware of the heat: People using blood pressure-lowering drugs, such as beta-blockers, should be cautious of developing heat illness when exercising. These medications and diuretics impair the ability to regulate body temperature or can cause dehydration.
  • Cool down: Adults with high blood pressure should extend the cool-down period of the workout. Blood pressure-lowering drugs, such as alpha-blockers, calcium channel blockers, and vasodilators may cause blood pressure levels to drop after abruptly ending exercise.
  • Weight loss:Overweight and obese adults with high blood pressure should combine regular exercise and weight loss efforts to effectively lower resting blood pressure.

Show Sources

SOURCES: Linda Pescatello, PhD, associate professor; director, Center for Health Promotion, University of Connecticut. Barry Franklin, PhD, director, cardiac rehabilitation, stress laboratory, William Beaumont Hospital, Royal Oak, Mich. Pescatello, L. Medicine & Science in Sports & Exercise, March 2004; vol 36: pp 533-553. News release, American College of Sports Medicine.

© 2004 WebMD, Inc. All rights Reserved. View privacy policy and trust info