By: Elinor Emesz and Igor Klibanov

Do you or someone you know have high blood pressure? If so, you’ll want to read this article, because this is going to be the most thorough, detailed, and comprehensive article on the internet about how to exercise for high blood pressure reduction. 

You know how you go to your doctor, and s/he prescribes medication? There’s a lot of precision behind that prescription. Your doctor will tell you: 

  • The name of the medication 
  • The dosage 
  • Whether to take it with food or away from food 
  • Whether to take it in the morning or the evening 

And yet, when your doctor recommends exercise, they just leave it at that: “you should exercise.” But no more details than that. You have to guess important details, like: 

  • Should you do cardio, resistance exercise (AKA strength training AKA weight lifting/training, which I’ll be using interchangeably throughout this article), or stretching?
  • How many days per week? 
  • At what intensity (heart rate, perceived exertion, or percentage of your maximum weight)? For what duration? 

…and more. 

Well, this article will give you that precision, whether you’re a lay person, a medical professional, or a fitness professional working with clients who have high blood pressure. 

So, I’ll go over what your doctor doesn’t, including: 

  • Is it safe to exercise when you have high blood pressure? 
  • The variables that are more important than the exercises themselves (FITT) How much exercise should you do? 
  • Exercises to do if you have high blood pressure 
  • Exercises to avoid 
  • Mechanisms by which exercise lowers high blood pressure 
  • Staying motivated and fitting exercise into your schedule 

Before we jump in, you’re probably questioning whether or not I am qualified to talk about physical exercise for high blood pressure. So, I’d like to introduce myself. Hi. 

I’m Igor.

I am the author of the Amazon bestselling book, High Blood Pressure Reversal Secrets, and I run an online personal training company called “Fitness Solutions Plus.” My team and I specialize in helping people lower their blood pressure. If you’d like to see if you qualify to work with my team and I, just fill out the application form on our home page.

Now that you know a bit more about me, let’s get started. 

Is It Safe To to Do Physical Exercise For High Blood Pressure? 

The real question that’s being said when you ask “is it safe to exercise when you have high blood pressure”, is even though you are exercising to help reduce your resting blood pressure, is it possible that you exercising will do more harm than good? The answer is yes, you can do more damage than good if your blood pressure is higher than 180/110 when you start. Don’t let this scare you into deciding to stop exercising.

It’s as simple as this: if your blood pressure is over 180/110 before you exercise, don’t do it until it comes down, and make sure you speak to your doctor to get clearance. Other than this, it is safe to exercise when you have high blood pressure, and also (in most cases) comes with these benefits: 

  • Helps you manage/cope with your blood pressure 
  • Makes your heart stronger and reduces the likelihood of you developing heart problems or getting a heart attack
  • Helps you manage your weight as well as maintain a healthy weight
  • Reduces stress levels 
  • Improves your mental health and emotional wellbeing 
  • Lowers blood sugar
  • Improves cholesterol and triglyceride profiles

The Variables That Are More Important Than The Exercises Themselves (F.I.T.T.) 

Exercise itself is great, however, in order for it to be beneficial, it has to be done the right way. It’s very important to know that when you exercise, the specific exercises you do are much less important than the other parameters of exercise prescription. These parameters are called the “FITT principle”. FITT is an acronym that stands for Frequency, Intensity, Time, and Type: 

  • Frequency is how often you exercise. In other words, how many times you exercise per week. 
  • Intensity is how much you exert yourself. 

○ For cardio, that’s relative to your maximal heart rate. To figure that out, you have to subtract your age from 220. For example, if you’re 60, you do 220-60, and then theoretically, your max heart rate would be 160. 

When it comes to strength training, the official definition is the percent of your 1 repetition maximum (1RM). That’s the max amount of weight you can lift for 1 repetition, but not two. The unofficial definition: how many reps you did relative to what you could have done. For example, if you could have done 10 but did 8, according to this definition, your intensity would be 80% of your 1 RM. For our purposes, and because it’s safer, the unofficial definition is actually better than the official definition.

  • Time is really only relevant to cardio, and is usually defined as how long you work out.

However, people use their time differently. For example, when two people are doing strength training for 30 minutes, one person might diligently move from one machine/exercise to the next, getting a lot done in a short amount of time, while another person might do an exercise then sit on their exercise machine, and scroll on their phones for the next 20 minutes, before moving on to the next exercise. Because of this, when it comes to strength training, it’s not measured in time, but in volume. That’s the number of sets and reps. For example, you might do 3 sets of 10 reps. 

  • Type is the type of exercise you do, and it’s usually either cardio, strength training, or stretching. 

It’s important to know the parameters of your exercise, because otherwise, it won’t be as effective as it can be. Here, I went over the basics of the FITT principles. If you want to learn more, here’s another one of my articles where I go much further into detail about the most important factors in an exercise program (hint: the exercises themselves are only the 4th most important variable). 

How Much Exercise Should You Do? 

Generally, the optimal number of days is 5-6 times a week (cardio: 3-5 times, strength training: 2-3 times). But optimal isn’t always realistic (especially if for the last 3+ months, you’ve been doing 0 times per week). But we’ll talk about that in a sec.

To be frank, everyone handles exercise differently and has different tolerance levels. The amount of times a week you should exercise also varies depending on what your goal is. If your goal is to maintain your fitness level, the number of times you exercise would be different than if your goal was to lose and maintain a healthy weight.

Because of these reasons, it’s not possible to say an exact number for how often everyone should exercise in a week. However, most goals require 5-6 days of exercise, the intensity varies depending on the goal. The one thing that almost never changes, no matter your goal, is that there should be 1 day per week that you rest, meaning you don’t do any physical exercise. Thus, the general amount for how many days per week you should exercise is 5-6. 

For cardio specifically, here’s the exercise prescription:

  • Intensity: between 60% and 85% of your maximal heart rate
  • Duration: 20-60 minutes
  • Frequency: 3-5 times a week. 
  • Type: up to you – jogging, cycling, dancing, swimming, etc. Doesn’t matter.

One study consisted of a training program, where for 30-45 minutes, subjects exercised at a moderate intensity 3 times per week, for 8 weeks.

This led to systolic and diastolic daytime blood pressure reduction of 6 and 3 mm Hg, respectively. If this was the decrease in blood pressure when participants exercised for 30-45 minutes 3 times a week, think about the decreases that can happen if you exercise 5 times a week, possibly even for more time.

And these reductions were for the average participant. The higher their blood pressure level was to begin with, the greater were the reductions.

For strength training, here’s the exercise prescription:

  • Frequency: 2-3 times per week
  • Volume: 2-3 sets of 10-15 repetitions
  • Number of exercises: 8-10, for different body parts.

One study tested this, where 3 days a week (non-consecutive days), subjects did 3 sets of 12 reps at 60% of their 1 repetition maximum (RM) of these exercises: 

  • Leg press 
  • Leg curl 
  • Chest press 
  • Lat pulldown 
  • Shoulder press 
  • Biceps curl 
  • Triceps extension 

The rest between each set was 1 minute, (wasn’t circuit training). After 12 weeks of using this program, systolic and diastolic blood pressure went down by 16 and 12 mmHg. This changed the group’s average blood pressure from stage 1 hypertension (150/93) to prehypertension (134/81), which is when your body is developing hypertension, or at least more likely to. Clearly, strength training has a big impact on lowering blood pressure, and the suggested 2-3 of 10-15 reps, 2-3 times per week is more impactful than others. 

Lastly, there’s something called handgrip training. When you do this, you use a device called a handgrip dynamometer, which is usually in a v-shape with a spring attached to it (though if you don’t have it, and don’t want to get it, if you just squeeze your own fists, it works as well). 

For the specifics, try to squeeze it with both your hands 

  • Use about 30% force 
  • Hold it for 2 minutes 
  • Let go and relax for 3 minutes 
  • Repeat it 3 more times for a total of 4 sets, 3 times a week. 

Handgrip training is known to lower blood pressure and can lower it by about 15 mmHg

In another systematic review, handgrip training is also shown to lower blood pressure.

For something that requires very little time (only 8 minutes, 3 times per week) and requires little to no equipment, this method is extremely powerful for blood pressure reduction.

There are many studies that look at the effects of different types of training where you exercise for different durations. In one study that compares the effects of steady training (where you maintain the same pace for 20+ minutes) against interval training (where you go fast for 30 seconds to 3 minutes, and then, you go slow for that same period of time). In the group that did steady-state training, both their systolic and diastolic blood pressure fell by 4-8 mm hg. The group that did interval training had a drop of 5-6 mm hg, but only in the diastolic blood pressure. So, from this, we can understand that steady-state training is more effective. 

In another study, researchers hoped to figure out what’s the least amount of time you need to exercise to reduce your high blood pressure. The researchers took 45 men with high blood pressure, the average blood pressure being 144.6/85.2, and divided them into 5 groups: 

  • Group 1 was the control group (they didn’t exercise). 
  • Group 2 exercised for 15 minutes at a low intensity of 40%. 
  • Group 3 exercised for 15 minutes at a moderate intensity of 60%. 
  • Group 4 exercised for 30 minutes at a low intensity of 40%. 
  • Group 5 exercised for 30 minutes at a moderate intensity of 60%. 

With a low intensity and only 15 minutes of exercise, the second group lowered their blood pressure by 5.6/2.1 mmHg. So, “what’s the least amount of exercise you can do and still get a benefit?” The answer is “just 15 minutes, at a fairly low intensity.” As I’m sure you can
tell, this is pretty great considering how much less effort it requires compared to other
durations and intensities, which also require more energy.

Yes, there were greater reductions with greater durations and intensities, but the overall message is that it doesn’t have to be an “all or nothing” type of deal. Where you either exercise for the perfect intensity, duration and frequency, or not at all. Even doing something easy for a short period of time will have positive effects on your blood pressure.

Exercises To Do If You Have High Blood Pressure 

For cardio, there are many different forms such as hiking, swimming, jogging, cycling, dancing, etc. To be honest, one isn’t better than the other, as long as the intensity, frequency, and duration/time are there. As we talked about earlier, the specific exercise routine you do doesn’t matter as much as how long, how often, and how much you exert yourself. 

A lot of people think that gardening is cardio, but it’s not, since it doesn’t cross the aerobic threshold, which is 65% of the maximal heart rate. Usually, walking also isn’t cardio since it doesn’t cross the aerobic threshold either… unless you’re walking on an incline. Remember – it’s not the activity that makes something cardio – it’s the intensity. Your pulse during the activity.

Unlike cardio, when it comes to strength training, the specific exercise you do actually does matter. So, with cardio, the best workouts to lower blood pressure are full-body workouts because the more muscle mass you work, the greater the reductions in blood pressure. For the specifics, choose a full-body exercise routine that includes 2-3 sets of 10-15 repetitions, and do it 2-3 times per week.

Exercises To Avoid 

You want to do good things for your body by exercising, and you sometimes hear the advice to “just move.” And while movement can be good, it can also be dangerous. You have to know how to move the right way, because exercising for high blood pressure reduction is different than exercising for fat loss, or toning, or other goals. So you want to make sure you’re doing it safely.

https://www.youtube.com/watch?v=4IUpj3yKbxU

When it comes to exercising with high blood pressure, there are a few things to be cautious about, since it could put you in danger. You should avoid any exercise: 

  • Where you get close to muscular failure. The closer you get to muscle failure, the higher your blood pressure level gets. In order to successfully avoid this, stay at least 3-5 reps away from failure. 

For example, if you know the max you can do is 20 reps, only do between 15 and 17 to make sure you’re on the safe side. 

  • Where you have to hold your breath under a high load. This is known as the Valsalva maneuver, which is a breathing method that increases your intrathoracic pressure, which results in your blood pressure increasing sharply. 
  • Anything where your legs are above your heart such as leg press, decline pushups, decline situps, and others. These exercises are important to avoid because when your heart has to pump blood against gravity like it does when your legs are over your heart, it raises your blood pressure more than when blood goes down from the heart. 
  • That has interval training (vigorous exercise) that takes you close to your maximal heart rate, since the closer you get to your maximal heart rate, the higher your blood pressure rises. 

Mechanisms By Which Exercise Lowers High Blood Pressure 

At the moment, there are 3 main mechanisms by which exercise (specifically cardio) lowers your blood pressure:

  1. Increasing Arterial Diameter 

When you have high blood pressure, a layer in your artery called the “intima-media” thickens. Just like a muscle would thicken from strength training, this layer in your artery would too, as a result of high blood pressure. 

One study found that cardio causes the thickness of intima-media to decrease, which would lead to the diameter increasing. 

  1. Increasing Bioavailability of Nitric Oxide

     

Nitric oxide is a molecule inside your body that helps “open up” your blood vessels. Everyone has it, but if you have high blood pressure, your body can’t use it. 

This study found that aerobic exercise re-sensitizes the cells to nitric oxide, allowing them to exert their artery-widening effects once again.

  1. Increasing Baroreflex Sensitivity

     

Baroreceptors send information to your nervous system about pressure and are found in your arteries. If you have high blood pressure, the sensitivity of your baroreceptors decreases, meaning they don’t send or receive clear signals from/to your nervous system. 

So, with more physical activity and more exercise, specifically cardio, the signals would be more clear and your nervous system would be able to better regulate your blood pressure. 

physical exercise for high blood pressure infographic