Guidelines for Exercise in Hypertensive Patients

Guidelines for Exercise in Hypertensive Patients

May 16, 2022

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Anuja Mhatre

Exercise has beneficial effects on blood pressure. The exercise prescription for extremely overweight/hypertensive patients is best formulated by an exercise specialist who is qualified to manage this population. Normal blood pressure (BP) is 120/80 mm Hg. High blood pressure is defined by a level greater than 130/80 mm Hg or 140/90 mm Hg in some cases.

A greater decline in night time diastolic BP compared to the wakefulness period (beneficial effect) was observed in a group that performed resistance training versus aerobic interval training. This study was conducted for a duration of 12 weeks in a group of hypertensive elderly subjects under treatment for BP control.

To ensure that the exercise programme does not pose any threat, these 5 tips must be kept in mind:

1. Parameters to be checked pre and post exercise:

Heart rate

  • Heart rate should be between 60-90 beats/min at rest.
  • During exercise it can rise up by 20-30 beats/min.
  • Post exercise heart rate should be checked immediately and repeated after 3 mins.

Monitoring BP

  • Resting BP is taken with your hand rested on the table at the level of the heart.
  • Resting BP (systolic) should be between 100-140 mmHg.
  • Resting BP (diastolic) should be between 60-100 mmHg.
  • Post exercise blood pressure should be checked immediately and repeated after 3 mins.

2. Hydration

If you exercise in hot and humid conditions, maintain fluid intake. Salts are needed if the sweat rate is high and exercise continues beyond an 1.5 hours. 250 ml per 15 mins of exercise is recommended. For electrolyte balance, consult an expert.

3. Breathing pattern

Voluntary holding of breath significantly increases the blood pressure as well as heart rate. Hence hypertensive patients should breathe normally while exercising.

4. Doctor’s clearance 

If your blood pressure fluctuates, a physician has to be consulted before starting a new exercise programme. Those who exercise regularly under expert supervision also require an annual stress test and ECG.  

5. Medication

If you exercise regularly, you must review your blood pressure medications with the doctor on a timely basis.

~Dr. Anuja Mhatre, Cardiac Rehab Physiotherapist

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