Hypertension

Frequency

The frequency remains at 3-5 sessions per week, integrating activity into everyday life.

Intensity

The intensity should be reduced to 50 to 75% HRmax. SBP increases in proportion to the intensity of the activity. Moderate intensity activity should be prescribed to avoid large increases in SBP. When HR and SBP are elevated, the myocardium is working harder and requires more oxygen due to a large increase in RPP. Hypertensive patients have a higher resting BP and when coupled with the associated increase in SBP during exercise the RPP value will be higher. Therefore, higher intensity exercise should be avoided until hypertension is controlled.

Type

Aerobic activities should be prescribed with the following considerations: it is important that all exercises are dynamic, as isometric exercise will increase BP. Isometric activities associated with the valsalva manoeuvre should be avoided. Resistance training should be prescribed using lower resistance and higher repetitions, ensuring the patients are not over-gripping equipment.

When prescribing exercise for hypertensive patients it is important to remember the physiological response of SBP when exercising a smaller muscle mass, i.e. arms versus legs. A smaller muscle mass in the upper body will result in less vasodilation and an increase in total resistance to blood flow. When exercising the upper limbs, there will be a greater BP increase, when compared to exercise of the lower limbs. This difference in SBP response to the use of the arms versus legs has important implications for myocardial oxygen con-sumption.The BP increase with upper limbs will increase the RPP. Upper body exercise will require a higher myocardial oxygen demand and therefore less activity can be performed prior to the onset of ischaemia. Care should be taken when including upper limb activities in a hypertensive participant's exercise regime.

TIme

Gradually increase duration prior to increasing intensity, as shown for a circuit design (see Chapter 5).

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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