How much is too much? Exercising with hypertension

The 29th of September marks Heart Health Day in South Africa, a country in which almost half of the adult population suffers from high blood pressure.

According to the World Health Organization (WHO), uncontrolled high blood pressure is dangerous because it can lead to heart attacks, heart enlargement, and eventually heart failure. Hypertension can also damage your blood vessels, and lead to aneurysms (weak spots and bulging in your vessels) and strokes. Additional negative health consequences include possible kidney failure, blindness, and cognitive impairment.

But there's hope! It's possible, in addition to any medication your healthcare provider recommends (always follow their advice), to help manage hypertension through exercise. Here are some things to keep in mind when you do so.

For how long and how hard should I be exercising each week?

As far as exercise goes, any physical activity that increases your heart and breathing rate will help to control high blood pressure. The exercise session should last for 30 to 60 minutes and be done at least three to five days each week. The intensity of the exercise session should be moderate (between 50 and 70% of your maximum heart rate).

"If you can't set aside that amount of time in one go, break it up into a few 5 to 10-minute bursts of activity each day," suggests Mari Leach, a biokineticist at Discovery Vitality. "Walk around the block during your lunch break and be physical in your daily tasks, such as taking the stairs instead of the lift. Mow the lawn yourself, or do some concerted laps instead of just paddling in a pool."

How do I calculate the heart rate I should exercise at?

You can work out the heart rate you should be exercising at using the calculation below:

Maximum heart rate = 220 minus your age. You then need to exercise at between 50% and 70% of this. Example: if you are 32 years old, your maximum heart rate is: 220 - 32 = 188 beats in a minute. A range of 50 to 70% of your maximum heart rate would be 95 to 132 beats a minute.

7 ways to stick at it

To keep your blood pressure within a normal range, you need to keep exercising. Leach advises that you schedule exercise into your daily routine: "Write it up in your diary or calendar like any other appointment." It usually takes about one to three months of regular exercise to see a positive change in your blood pressure.

Here are some ways to stay motivated:

1. Avoid overdoing it. Gradually increase your activity level over time.
2. Change your routine if you start to get bored or demotivated. Pick an activity you enjoy, like dancing, swimming or martial arts.
3. Wait for at least 1 ½ hours after eating before exercising.
4. Schedule exercise into your daily routine - write it up in your diary like any other appointment.
5. Keep a record of your exercise and your blood pressure readings.
6. Exercise with a friend - this will help you to stay motivated.
7. Go for fitness tests periodically. Record your exercise progress on a chart.

Safety tips to avoid overstraining your heart

For most people who have high blood pressure, exercise is quite safe. Caution is generally required for people over 50 years of age and those with cardiovascular disease. For these people, advice from an exercise specialist is recommended before starting an exercise programme. Follow these tips too:

• Pace yourself, balancing your activities with rest periods.
• Don't ignore any sort of pain or dizziness. Stop the activity immediately and see your doctor.
• Avoid lifting heavy weights as this can increase the pressure within your body. When lifting weights, exhale as you exert effort.
• Avoid exercising in extreme weather temperatures as this may interfere with your circulation and make breathing difficult.
• Don't exercise if you're feeling unwell or have a fever. This can put strain on your heart.
• Your systolic pressure will increase during exercise, while diastolic pressure may remain the same or drop. This is normal.
• Avoid extremely strenuous activities as they may place extra stress on your heart.

Talk to your doctor regularly about your exercise routine and monitoring your blood pressure - and remember to exercise smartly and safely to enjoy the health benefits of lower blood pressure!