High blood pressure often referred to as hypertension is estimated to affect 1 in 4 adults worldwide and puts these individuals at high risk of heart attack or stroke (Gov.Uk, 2017). However, by making healthier choices in your diet and doing more exercise each day, blood pressure will reduce and alleviate the risks along with it.
Exercise Considerations
Many individuals suffering from hypertension feel cautious at the idea of starting an exercise programme. However, a well-designed exercise programme can in fact lower blood pressure and reduce risks of the condition worsening (Kokkinos and Papademetriou, 2000). I recently started working with a client who had been diagnosed with hypertension. Before planning a programme, I refreshed myself on the current guidelines regarding exercise considerations for hypertensive clients. I read multiple sources, but a key one of these was ACSM's Exercise for Hypertension (Zaleski, 2019). In this paper I was reminded of the three main exercise considerations when training a client with hypertension.
3 Main Exercise Considerations
1) The client's blood pressure should be monitored before and after the session.
2) A 15- minute warm-up is essential, to prevent sudden pressure being placed on the heart.
3) No lifting above the heart, to prevent extra pressure of pumping blood upwards against gravity.
Throughout the 8 weeks, I monitored intensity through heart rate and rate of perceived exertion scale (RPE Scale). The RPE Scale can be used during exercise to track the intensity that you believe you are working at.
Monitoring heart rate during exercise is important and can be done using a smart watch or counting your pulse. Although it should be noted that if you are suffering from hypertension and prescribed to medication to lower blood pressure, heart rate could be recorded low even when working at high intensities. I experienced this with my client as she often struggled to raise heart rate during exercise.
My client was prescribed to spironolactone, a common medication to lower her blood pressure. She reported that the medication sometimes caused her to feel faint, a main side effect of the drug (NICE, 2022). It is important that if you ever feel faint to terminate exercise immediately.
Limitations
A limitation I experienced when training my client, was that she sometimes had hospital appointments and had to miss sessions. When this happened, I provided the client with a short video of exercises and stretches that she could perform in the comfort of her own home. Anyone can easily perform exercises at home, here is a link to a short video with some movement preparation and stretches performed by me to get you started... https://youtu.be/ugyhqTkdi8c
Motivation
It is important to identify what motivates you. To make the sessions engaging for my client, who often lacked motivation, I found that the client used to be a PE teacher where she enjoyed sports and being competitive. So, I introduced ball games into our training sessions. Medicine ball throws were included, and the client was encouraged to throw the ball at high intensity. The client seemed to really enjoy this part of the work out, so I tracked her progress and made it competitive. Each week I would inspire her to beat last week's score. The client's blood pressure decreased significantly each week; I believe this also acted as motivation for the client.
Consequently, I highly recommend you track your blood pressure before and after performing exercise and recording it throughout your exercise programme. Not only for your own safety to check your blood pressure is safe to exercise, but also to track the effects the exercise has on your blood pressure.
References
Berg K, Wood-Dauphinee S, Williams JI: The Balance Scale: Reliability assessment for elderly residents and patients with an acute stroke. Scand J Rehab Med, 27:27-36, 1995.
Gov.Uk Health matters: combating high blood pressure, 24 January 2017.
Kokkinos, P.F. and Papademetriou, V., 2000. Exercise and hypertension. Coronary artery disease, 11(2), pp.99-102.
National Institute for Health and Care Excellence, Spironolactone 2022.
Zaleski, A., 2019. Exercise for the Prevention and Treatment of Hypertension–Implications and Application. American College of Sports Medicine.
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