Exercise & Hypertension

Hypertension leads to an increased risk of cardiovascular disease, stroke, heart failure, peripheral artery disease and chronic kidney disease.

Cardiovascular exercise assists in reduction of resting blood pressure (BP) in hypertensive individuals. Greater health benefits may be supplemented with moderate intensity resistance training.

Special Considerations

As a general thumb of rule, the following exercise prescription is recommended:

Individuals with severe or uncontrolled blood pressure (BP) should add exercise training to their treatment plan only after first being evaluated by their physician and being prescribed antihypertensive medication.

  • When at rest, do not exercise if:

Systolic Blood Pressure (SBP) > or equal 200 mm Hg and/or Diastolic Blood Pressure (DBP) > or equal 110mm Hg

  • When exercising, be cautious:

Do not exceed SBP > or equal 220 mm Hg and/or DBP > or equal 105 mm Hg.

Antihypertensive medications such as beta-blockers, calcium channel blockers, and vasodilators may lead to sudden reductions in post-exercise BP. Extend and monitor the cool-down period carefully in these situations. Avoid the Valsalva manoeuvre forceful exhalation while keeping the mouth and nose closed) during resistance training to prevent sudden increase in BP.

Recomended Exercises

1. Aerobic Exercise

Frequency Intensity Time Type
At least 3 – 4 sessions per week Moderate intensity at 50-70% Heart rate maximum * Accumulate 30-60 minutes in bouts of at least 10 minutes each Jogging, swimming, brisk walking, cycling

* A simple measure of exercise intensity: During moderate intensity exercise, you should be able to talk but not sing.

2. Resistance Training

Frequency Intensity Time Type
2 – 3 days per week 60 – 80% of 1 repetition maximum (1-RM)* 8 – 10 exercises per session, target major muscle group (e.g. biceps, abdominal, quadriceps) 1 set of 8 – 12 repetitions (may progress to more than 1 set) Resistance machines and free weights (e.g. dumbbells and barbells); Bodyweight exercise (e.g. squats and push up)

* 1-RM: the maximum weight an individual can lift with one repetition.

3. Flexibility / Balance Training

Frequency Intensity Time Type
2 – 3 days per week Stretch to range of motion tightness 8 – 10 stretches involving both upper and lower body Hold for 15 – 30 seconds per stretch; 2 – 4 repetitions per stretch Sit & reach, triceps stretch Tai Chi, stand on one foot with support

* 1-RM: the maximum weight an individual can lift with one repetition.