Nearly 70 million Americans have high blood pressure. This elevated pressure, termed hypertension, has been referred to as the ‘’silent killer’’; while often symptom-less, it substantially increases the risk for potentially fatal outcomes such as heart attack, stroke, heart failure and kidney disease. Regular blood pressure checks are a simple and inexpensive way to identify hypertension. Still, up to 30% of affected people are unaware they have hypertension.

While hypertension can affect anyone, it is particularly prevalent among African Americans, middle-aged and elderly individuals, obese people, heavy drinkers, women taking oral contraceptives and people with diabetes.

Gauging Blood Pressure

Normal resting blood pressure is a pressure less than 120/80 mmHg. The first number, 120, represents the pressure against the artery walls when the heart contracts (systolic blood pressure). The second number, 80, is the pressure against the artery walls during the resting phase (between heart beats) and is termed diastolic blood pressure.

There is a direct relationship between blood pressure and cardiovascular disease risk. That is, the higher the blood pressure, the greater the risk. For this reason, high blood pressure is divided into several categories that help determine appropriate treatment. “Prehypertension” is defined as a systolic blood pressure reading of 120–139 mmHg and/or a diastolic blood pressure of 80–89 mmHg.

Stage 1 hypertension is defined as a blood pressure of 140–159/90–99 mmHg as measured on at least two occasions. Stage 2 hypertension is a blood pressure >160/100 mmHg.
All individuals with elevated blood pressure benefit from adhering to the lifestyle modification recommendations advocated in the accompanying table.

Hypertension and Exercise

A regular cardiovascular exercise program can help prevent hypertension and lead to substantial declines in systolic blood pressure.

For maximal benefit, it is recommended that individuals engage in moderate-intensity exercise (40–60% of V•O2max) for at least 30 minutes on most, preferably all, days of the week. Walking, swimming, cycling and low-impact aerobics are excellent options. As your aerobic conditioning improves, add a circuit-training program that emphasizes low-resistance, high-repetition exercises. (Note: When engaging in resistance training, avoid holding your breath, as this can lead to rapid increases in blood pressure and heart rhythm abnormalities.) New exercisers should ease into an exercise program by starting slow and developing a consistent routine before gradually increasing exercise frequency, intensity or duration.

Importantly, if you have hypertension, consult your physician before beginning an exercise program. This is especially critical for those who take blood pressure medications, which can alter the heart-rate response to exercise. And if you would like a little bit of extra help translating exercise recommendations into a safe, effective and fun exercise program, go to http://www.acefitness.org/findanacepro to find an ACE-certified Personal Trainer or Advanced Health & Fitness Specialist near you.

Additional Resources

National Heart, Lung, and Blood Institute
The American Hearth Association