Lack of time is cited as a barrier for people engaging in regular physical activity 82 and HIIT offers a way to derive exercise benefits in a more time efficient manner. HIIT should not be confused with sprint interval training SIT that has participants exercising supra-maximally e.

SIT has not been investigated in individuals with hypertension and should be avoided by people who do not engage in regular exercise because of the increased albeit small CV risk potential.

Compared to conventional moderate intensity continuous training over longer time intervals in patients with hypertension, HIIT has been shown to produce significantly greater improvements in hour ambulatory SBP and DBP, VO 2 max, total peripheral resistance, and left ventricular systolic and diastolic function.

HIIT appears to be safe and well tolerated in higher risk individuals e. Although adverse events from HIIT appear to be rare, protocol details regarding how these data may have been collected are generally lacking.

There is also no clear consensus as to the best HIIT methods for general health in clinical populations, and there is a need for more studies in people with hypertension. These studies should provide details regarding adverse events as well as specifics on the methods of event data collection e.

A basic HIIT program recommended on review of current data is provided in Table 2. a For people using beta blocker medication, this should be a rating of perceived exertion RPE 15—17 on the Borg 6—20 scale. Adapted from ref. Even in people with apparently normal resting BP, exercise-induced hypertension EIH is probably indicative of underlying hypertension that has failed detection using resting BP screening methods.

Evidence to support this although not yet definitive comes firstly from the high prevalence of masked hypertension normal clinic BP but elevated hour ambulatory BP among people with EIH. To our knowledge, there is no evidence that EIH increases risk for adverse events during the exercise bout where the EIH is observed.

On the contrary, regular exercise should be beneficial for these people. A key message from the presentation of EIH is that it should be regarded as an indication to undertake out-of-clinic BP monitoring to confirm true underlying BP and respond with treatment accordingly.

Regular exercise can reduce BP beyond that achieved with antihypertensive medications and this could lead to symptomatic excessive BP lowering. A review of medications and BP control in those taking up exercise programs experiencing symptoms is therefore suggested, again, with BP measured preferentially out of the office to avoid white coat effects.

Beta blockers and diuretics can alter thermoregulation during exercise, 37 , 76 , which has led to a precautionary call to those taking these medications to limit exercise intensity in hot or humid weather, as well as ensuring adequate hydration and use of clothing to encourage cooling.

Populations at increased risk include the elderly and those with preexisting coronary artery disease; however, people with diabetes, women, and also those who are obese for which there is higher prevalence of hypertension may also be vulnerable.

Instead people should exercise in areas with lower ambient pollutant concentration, which may include parks, recreation areas, and quiet roads. Acute CV events induced by exercise occur more commonly in older people with atherosclerotic disease or younger people with congenital or hereditary heart disease.

This is especially relevant to higher risk patients or those wishing to partake in high-intensity physical activity. A summary of special exercise considerations is presented in Table 3. The comparative health effects of aerobic vs.

resistance training have not been fully elucidated in people with hypertension, but where BP lowering is a major goal of exercise, then aerobic activity appears to be the preferred method to achieve this.

There are promising data on the CV protective effects of HIIT and isometric resistance training, but with only limited data available in people with hypertension, more work is needed in this area. Exercise volume thresholds at which maximum benefits are derived are difficult to determine, although only a small but consistent weekly quantity of moderate exercise can have significant health benefits owing to the graded inverse relationship between exercise volume and adverse clinical outcomes.

The benefits of regular physical activity outweigh the risks and should be recommended for the majority of people with hypertension. was supported by a National Health and Medical Research Council of Australia Career Development Award reference was supported by a National Health and Medical Research Council of Australia Postdoctoral Fellowship reference Whelton PK He J Appel LJ Cutler JA Havas S Kotchen TA Roccella EJ Stout R Vallbona C Winston MC Karimbakas J.

Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program.

JAMA ; : — Google Scholar. Blair SN Kampert JB Kohl HW III Barlow CE Macera CA Paffenbarger RS Jr Gibbons LW. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women.

Sharman JE Stowasser M. Australian association for exercise and sports science position statement on exercise and hypertension.

J Sci Med Sport ; 12 : — Hordern MD Dunstan DW Prins JB Baker MK Singh MA Coombes JS. Exercise prescription for patients with type 2 diabetes and pre-diabetes: a position statement from Exercise and Sport Science Australia. J Sci Med Sport ; 15 : 25 — Smart NA Williams AD Levinger I Selig S Howden E Coombes JS Fassett RG.

J Sci Med Sport ; 16 : — Rethorst CD Wipfli BM Landers DM. The antidepressive effects of exercise: a meta-analysis of randomized trials. Sports Med ; 39 : — Cooney GM Dwan K Greig CA Lawlor DA Rimer J Waugh FR McMurdo M Mead GE.

Exercise for depression. Cochrane Database Syst Rev ; 9:CD Hayes SC Spence RR Galvao DA Newton RU. Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. Morton AR Fitch KD.

Australian association for exercise and sports science position statement on exercise and asthma. J Sci Med Sport ; 14 : — Fransen M McConnell S Bell M. Exercise for osteoarthritis of the hip or knee. Cochrane Database Syst Rev ; 3; CD A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, a systematic analysis for the Global Burden of Disease Study Lancet ; : — Annemans L Lamotte M Clarys P Van den Abeele E.

Health economic evaluation of controlled and maintained physical exercise in the prevention of cardiovascular and other prosperity diseases. Eur J Cardiovasc Prev Rehabil ; 14 : — Blumenthal JA Babyak MA Hinderliter A Watkins LL Craighead L Lin PH Caccia C Johnson J Waugh R Sherwood A.

Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med ; : — Conlin PR Chow D Miller ER III Svetkey LP Lin PH Harsha DW Moore TJ Sacks FM Appel LJ.

The effect of dietary patterns on blood pressure control in hypertensive patients: results from the Dietary Approaches to Stop Hypertension DASH trial. Am J Hypertens ; 13 : — Harrington JM Fitzgerald AP Kearney PM McCarthy VJ Madden J Browne G Dolan E Perry IJ.

DASH diet score and distribution of blood pressure in middle-aged men and women. Am J Hypertens ; 6 : 6. Parikh A Lipsitz SR Natarajan S.

Association between a DASH-like diet and mortality in adults with hypertension: findings from a population-based follow-up study. Am J Hypertens ; 22 : — Appel LJ Brands MW Daniels SR Karanja N Elmer PJ Sacks FM.

Dietary approaches to prevent and treat hypertension. A scientific statement from the American Heart Association. Hypertension ; 47 : — Churilla JR Ford ES. Comparing physical activity patterns of hypertensive and nonhypertensive US adults.

Am J Hypertens ; 23 : — Faselis C Doumas M Kokkinos JP Panagiotakos D Kheirbek R Sheriff HM Hare K Papademetriou V Fletcher R Kokkinos P. Exercise capacity and progression from prehypertension to hypertension.

Hypertension ; 60 : — Kodama S Saito K Tanaka S Maki M Yachi Y Asumi M Sugawara A Totsuka K Shimano H Ohashi Y Yamada N Sone H. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis.

Faselis C Doumas M Pittaras A Narayan P Myers J Tsimploulis A Kokkinos P. Hypertension ; 64 : 30 — Berry JD Willis B Gupta S Barlow CE Lakoski SG Khera A Rohatgi A de Lemos JA Haskell W Lloyd-Jones DM.

Lifetime risks for cardiovascular disease mortality by cardiorespiratory fitness levels measured at ages 45, 55, and 65 years in men: the Cooper Center Longitudinal Study. J Am Coll Cardiol ; 57 : — Gordon-Larsen P Nelson MC Popkin BM. Longitudinal physical activity and sedentary behavior trends: adolescence to adulthood.

Am J Prev Med ; 27 : — Carnethon MR Gulati M Greenland P. Prevalence and cardiovascular disease correlates of low cardiorespiratory fitness in adolescents and adults. Cornelissen VA Fagard RH. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors.

Hypertension ; 46 : — Cornelissen VA Buys R Smart NA. Endurance exercise beneficially affects ambulatory blood pressure: a systematic review and meta-analysis. J Hypertens ; 31 : — Taylor-Tolbert NS Dengel DR Brown MD McCole SD Pratley RE Ferrell RE Hagberg JM. Ambulatory blood pressure after acute exercise in older men with essential hypertension.

Am J Hypertens ; 13 : 44 — Pagonas N Dimeo F Bauer F Seibert F Kiziler F Zidek W Westhoff TH. The impact of aerobic exercise on blood pressure variability.

J Hum Hypertens ; 28 : — Radak Z Chung HY Koltai E Taylor AW Goto S. Exercise, oxidative stress and hormesis.

Ageing Res Rev ; 7 : 34 — Dawson EA Green DJ Cable NT Thijssen DH. Effects of acute exercise on flow-mediated dilatation in healthy humans. J Appl Physiol ; : — Fagard RH Cornelissen VA. Effect of exercise on blood pressure control in hypertensive patients.

Eur J Cardiovasc Prev Rehabil ; 14 : 12 — Meredith IT Friberg P Jennings GL Dewar EM Fazio VA Lambert GW Esler MD. Exercise training lowers resting renal but not cardiac sympathetic activity in humans.

Hypertension ; 18 : — Grassi G Seravalle G Calhoun DA Mancia G. Physical training and baroreceptor control of sympathetic nerve activity in humans. Hypertension ; 23 : — Nami R Mondillo S Agricola E Lenti S Ferro G Nami N Tarantino M Glauco G Spanò E Gennari C.

Aerobic exercise training fails to reduce blood pressure in nondipper-type hypertension. King AC Oman RF Brassington GS Bliwise DL Haskell WL. Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial.

JAMA ; : 32 — Gangwisch JE. A review of evidence for the link between sleep duration and hypertension. Am J Hypertens ; 27 : — Pescatello LS Franklin BA Fagard R Farquhar WB Kelley GA Ray CA. American College of Sports Medicine position stand.

Exercise and hypertension. Med Sci Sports Exerc ; 36 : — Pollock ML Franklin BA Balady GJ Chaitman BL Fleg JL Fletcher B Limacher M Pina IL Stein RA Williams M Bazzarre T. AHA Science Advisory.

Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: an advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association; Position paper endorsed by the American College of Sports Medicine.

Circulation ; : — Benton MJ. Safety and efficacy of resistance training in patients with chronic heart failure: research-based evidence. Prog Cardiovasc Nurs ; 20 : 17 — Bertovic DA Waddell TK Gatzka CD Cameron JD Dart AM Kingwell BA.

Muscular strength training is associated with low arterial compliance and high pulse pressure. Hypertension ; 33 : — Carlson DJ Dieberg G Hess NC Millar PJ Smart NA. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc ; 89 : — Sumimoto T Hamada M Muneta S Shigematsu Y Fujiwara Y Sekiya M Kazatani Y Hiwada K.

Influence of age and severity of hypertension on blood pressure response to isometric handgrip exercise. J Hum Hypertens ; 5 : — Araujo CG Duarte CV Goncalves Fde A Medeiros HB Lemos FA Gouvea AL. Hemodynamic responses to an isometric handgrip training protocol.

Arq Bras Cardiol ; 97 : — McGowan CL Levy AS Millar PJ Guzman JC Morillo CA McCartney N Macdonald MJ. Acute vascular responses to isometric handgrip exercise and effects of training in persons medicated for hypertension.

Am J Physiol Heart Circ Physiol ; : Taylor AC McCartney N Kamath MV Wiley RL. Isometric training lowers resting blood pressure and modulates autonomic control.

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Governance What we do Our work Our campaigns. Our policies Using this website Contact us Leave your feedback. Blood Pressure UK BPUK Your Blood Pressure How to lower your blood pressure Healthy living Exercise, physical activity and your blood pressure. Exercise, physical activity and your blood pressure.

A lack of physical activity is linked to high blood pressure, and being more active will lower your blood pressure. How does being active help lower your blood pressure?

It can give you more energy and lift your mood, and even improve your cognitive function. Is it safe to exercise if you have high blood pressure? Blood pressure level Is it safe to be more active? Use the table below to get an idea of the types of exercises and activities that are safe and those to avoid: Helpful and unhelpful activities for lowering blood pressure Activities that are good for your blood pressure Activities to avoid Cycling Brisk walking Swimming Dancing Gardening Tennis Jogging Weight lifting Squash Skydiving Sprinting Scuba diving - you will need a certificate from your doctor Talk to your doctor or nurse before starting any of these How much exercise should you do?

Tips for getting more active Some people find it difficult to find the time to be active, or you may find it hard to keep active for 30 minutes in one go. Couch to 5K is a plan to help absolute beginners gradually build up to running five kilometers.

Take up the 10, Steps Challenge, where you aim to walk 10, steps every day. Ramblers and Wellbeing Walks both organise free walks all over the country every week, or find your nearest walking group.

Classes are available around the country and can be cheap or even free. Exercise Intensity and Incidence of Metabolic Syndrome: The SUN Project. Am J Prev Med. Inflammation in atherosclerosis. Jonathan Myers, Paul McAuley, Carl J Lavie, Jean-Pierre Despres, Ross Arena PK. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status.

Prog Cardiovasc Dis. You T, Arsenis NC, Disanzo BL, Lamonte MJ. Effects of exercise training on chronic inflammation in obesity: Current evidence and potential mechanisms.

Sport Med. High-Risk Coronary Plaque Regression After Intensive Lifestyle Intervention in Nonbstructive Coronary Disease: A Randomized Study. JACC Cardiovasc Imaging. Coronary atheroma regression and plaque characteristics assessed by grayscale and radiofrequency intravascular ultrasound after aerobic exercise.

Am J Cardiol. Intensive lifestyle changes for reversal of coronary heart disease. J Am Med Assoc. High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease.

Eur J Cardiovasc PrevRehabil. Wewege MA, Ahn D, Yu J, Liou K, Keech A. High-intensity interval training for patients with cardiovascular disease-is it safe?

A systematic review. Vigorous intensity exercise is essentially safe for coronary heart disease patients. Evid based Med. Fletcher B, Berra K, Ades P, et al. Managing abnormal blood lipids: A collaborative approach. org Caspersen, CJ; Powell, KE; Christenson G. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.

Public Heal Rep. Both aerobic endurance and strength training programmes improve cardiovascular health in obese adults. Clin Sci. Exercise training and cardiac rehabilitation in primary and secondary prevention of coronary heart disease. Mayo Clin Proc.

Franckowiak, SC; Dobrosielski, DA; Reilley, SM; Walston, JD; Andersen R. Maximal heart rate prediction in adults that are overweight or obese. J Strength Cond Res.

Effects of exercise training on heart rate recovery in patients with chronic heart failure. Should high-intensity-aerobic interval training become the clinical standard in heart failure? Hear Fail Rev. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: A pilot study.

High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: implications for exercise adherence. J Sport Sci. Taylor JL, Holland DJ, Spathis JG, et al. Guidelines for the delivery and monitoring of high intensity interval training in clinical populations.

Physical Activity for Health: What Kind? How Much? How Intense? On Top of What? Annu Rev Public Heal. Download article. Community Events Calendar Advertise your course in our community calendar. BCS Annual Conference Save the Date: 3 - 5 June Related Links Like BCS on Facebook Follow BCS on Twitter Updates on courses Join our case discussion group on MedShr.

CVD remains a leading cause of morbidity and mortality suggesting a need for improving its management Exercise is important in the management of specific conditions, e.

This is particularly important given that the first reading is often the highest reading. Preferably, the same exercise professional should measure BP on the same patient and using the same BP monitoring device. Patients with suspected white-coat hypertension may be referred to their healthcare provider for proper evaluation.

Appropriate preparticipation health screening should be implemented to identify at-risk individuals who may require medical clearance before they begin an exercise program PMID: Although exercise is safe for most individuals, there is a small risk of cardiovascular complications in certain susceptible individuals, particularly among sedentary adults with known or underlying CVD who perform vigorous-intensity exercise they do not usually engage in.

As such, individuals with hypertension cleared to exercise by the preparticipation algorithm or healthcare provider should be encouraged to progress gradually, avoiding large increases in any of the components of the FITT. Progression may be individualized based on tolerance and preference in a conservative manner.

Lifestyle modifications, such as regular aerobic exercise, are fundamental for the prevention, treatment, and control of hypertension. When lifestyle interventions are not effective in achieving treatment BP goals, antihypertensive therapy may be required to optimize CVD risk reduction.

Whenever possible, an interdisciplinary, collaborative approach involving the patient, healthcare provider s , and exercise professional will largely improve lifestyle and pharmaceutical adherence, translating to greater BP control and overall health, which is the ultimate goal in the treatment of hypertension.

Recommended Reading: New Blood Pressure Guidelines. Preparticipation Screening. Author : Amanda Zaleski, PhD is an American Heart Association Postdoctoral Fellow in the Department of Kinesiology at the University of Connecticut. She is also a Project Manager and Evidence-Based Credentialed Analyst for the forthcoming ACSM Hypertension Position Stand Update and Co-Chair of the Communications Committee for New England ACSM.

In This Section:. Exercise for the Prevention and Treatment of Hypertension - Implications and Application Amanda Zaleski Feb. Emerging research suggests that dynamic resistance exercise may also serve as an efficacious strategy to lower blood pressure to levels similar to aerobic exercise.

The goal of preparticipation screening should be to risk classify individuals at risk for an adverse or life threatening response to exercise while decreasing barriers to physical activity participation. Cardiovascular disease CVD is the leading cause of death in the United States U.

You can calculate it by determining your body mass index use the BMI calculator at the bottom of the page. Exercise lowers blood pressure by reducing blood vessel stiffness so blood can flow more easily.

The effects of exercise are most noticeable during and immediately after a workout. Lowered blood pressure can be most significant right after you work out. So, health professionals theorize, the ideal way to combat high blood pressure might be to break up your workout into several sessions throughout the day.

In fact, one study found that three minute walks a day more effectively prevented future blood pressure spikes than one minute trek per day.

The muscle power needed to climb a road on an incline, a hill or a mountain can help you achieve a greater level of fitness.

Physical activity such as hiking can lower blood pressure up to 10 points. Blood pressure readings were even more optimal in a study when participants ambled along at a slow 1-mile-per-hour pace at desk-based treadmills for at least 10 minutes every hour, or pedaled stationary bikes under a desk for at least 10 minutes every hour.

Although it sounds counterintuitive, weight training or lifting can reduce blood pressure. Strength training actually raises blood pressure levels temporarily, but can help overall fitness, which will improve blood pressure levels as well.

Sluik D, Buijsse B, Muckelbauer R, et al. Physical activity and mortality in individuals with diabetes mellitus: A prospective study and meta-analysis. Arch Intern Med. org Iabetes D, Revention P, Rogram P, Esearch R, Roup G.

N Engl J Med. Accessed October 1, org Hidalgo-Santamaria M, Fernandez-Montero A, Martinez-Gonzalez MA, et al. Exercise Intensity and Incidence of Metabolic Syndrome: The SUN Project. Am J Prev Med. Inflammation in atherosclerosis.

Jonathan Myers, Paul McAuley, Carl J Lavie, Jean-Pierre Despres, Ross Arena PK. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status.

Prog Cardiovasc Dis. You T, Arsenis NC, Disanzo BL, Lamonte MJ. Effects of exercise training on chronic inflammation in obesity: Current evidence and potential mechanisms. Sport Med. High-Risk Coronary Plaque Regression After Intensive Lifestyle Intervention in Nonbstructive Coronary Disease: A Randomized Study.

JACC Cardiovasc Imaging. Coronary atheroma regression and plaque characteristics assessed by grayscale and radiofrequency intravascular ultrasound after aerobic exercise. Am J Cardiol. Intensive lifestyle changes for reversal of coronary heart disease.

J Am Med Assoc. High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease.

Eur J Cardiovasc PrevRehabil. Wewege MA, Ahn D, Yu J, Liou K, Keech A. High-intensity interval training for patients with cardiovascular disease-is it safe? A systematic review. Vigorous intensity exercise is essentially safe for coronary heart disease patients.

Evid based Med. Fletcher B, Berra K, Ades P, et al. Managing abnormal blood lipids: A collaborative approach. org Caspersen, CJ; Powell, KE; Christenson G. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.

Public Heal Rep. Both aerobic endurance and strength training programmes improve cardiovascular health in obese adults. Clin Sci. Exercise training and cardiac rehabilitation in primary and secondary prevention of coronary heart disease.

Mayo Clin Proc. Franckowiak, SC; Dobrosielski, DA; Reilley, SM; Walston, JD; Andersen R. Maximal heart rate prediction in adults that are overweight or obese. J Strength Cond Res. Effects of exercise training on heart rate recovery in patients with chronic heart failure. Should high-intensity-aerobic interval training become the clinical standard in heart failure?

Hear Fail Rev. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: A pilot study. High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: implications for exercise adherence.

J Sport Sci. Taylor JL, Holland DJ, Spathis JG, et al. Guidelines for the delivery and monitoring of high intensity interval training in clinical populations.

Physical Activity for Health: What Kind? How Much? How Intense?