Exercise: A drug-free approach to lowering high blood pressure

Your risk of high blood pressure (hypertension) increases with age, but getting some exercise can make a big difference. And if your blood pressure is already high, exercise can help you control it. Don't think you need to immediately run a marathon or join a gym. Instead, start slow and work more physical activity into your daily routine.

How exercise can lower your blood pressure

Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. As a result, the force on your arteries decreases, lowering your blood pressure.

Blood pressure is measured in millimeters of mercury (mm Hg). Normal blood pressure is less than 120 mm Hg for the top number (systolic) and less than 80 mm Hg for the bottom number (diastolic). Becoming more active can lower both your top and bottom blood pressure numbers. How much lower isn't entirely clear, but studies show reductions from 4 to 12 mm Hg diastolic and 3 to 6 mm Hg systolic.

Regular exercise also helps you maintain a healthy weight — another important way to control blood pressure. If you're overweight, losing even 5 pounds (2.3 kilograms) can lower your blood pressure.

To keep your blood pressure healthy, you need to keep exercising on a regular basis. It takes about one to three months for regular exercise to have an impact on your blood pressure. The benefits last only as long as you continue to exercise.

How much exercise do you need?

You should try to get at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of the two. Aim for at least 30 minutes of aerobic activity most days of the week. If you're not used to exercising, work slowly toward this goal. You can break up your workout into three 10-minute sessions of aerobic exercise and get the same benefit as one 30-minute session.

Any activity that increases your heart and breathing rates is considered aerobic activity, including:

• Active sports, such as basketball or tennis
• Bicycling
• Climbing stairs
• Dancing
• Gardening, including mowing the lawn and raking leaves
• Jogging
• Swimming
• Walking

A combination of aerobic and weight (resistance) training seems to provide the most heart-healthy benefits.

If you sit for several hours a day, try to take 5- to 10-minute breaks each hour to stretch and move. A non-active (sedentary) lifestyle is linked to many chronic health conditions, including high blood pressure. Try low-intensity activities such as taking a quick walk or even going to the kitchen or breakroom to get a drink of water. Setting a reminder on your phone or computer may be helpful.

When you need your doctor's OK

Sometimes it's best to check with your doctor before you jump into an exercise program, especially if:

• You have a chronic health condition such as diabetes, heart disease or lung disease.
• You have high cholesterol or high blood pressure.
• You've had a heart attack.
• You have a family history of heart-related problems before age 55 in men and age 65 in women.
• You feel pain or discomfort in your chest, jaw, neck or arms during activity.
• You become dizzy with activity.
• You smoke or recently quit smoking.
• You're overweight or obese.
• You're unsure if you're in good health or you haven't been exercising regularly.

Some medications, including high blood pressure drugs, affect your heart rate and your body's response to exercise. Also, if you take blood pressure drugs and recently increased your activity level, ask your doctor if you need to adjust your dose. For some people, getting more exercise reduces their need for blood pressure medication.

Check your heart rate

To reduce the risk of injury while exercising, start slowly. Remember to warm up before you exercise and cool down afterward. Build up the intensity of your workouts gradually.

Use these steps to check your heart rate during exercise:

• Stop briefly.
• Take your pulse for 15 seconds. To check your pulse over your carotid artery, place your index and third fingers on your neck to the side of your windpipe. To check your pulse at your wrist, place two fingers between the bone and the tendon over your radial artery — which is located on the thumb side of your wrist.
• Multiply this number by 4 to calculate your beats per minute.

Here's an example: You stop exercising and take your pulse for 15 seconds, getting 37 beats. Multiply 37 by 4, to get 148 beats per minute.

Stop if you feel pain

Stop exercising and seek immediate medical care if you have any warning signs of possible heart problems during exercise, including:

• Chest, neck, jaw or arm pain or tightness
• Dizziness or faintness
• Severe shortness of breath
• An irregular heartbeat

Monitor your progress

The only way to detect and manage high blood pressure is to keep track of your blood pressure readings. Have your blood pressure checked at each doctor's visit and use a home blood pressure monitor. When measuring your blood pressure at home, it's best to do so at the same time every day.