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What Effects Does Exercise Have On High Blood Pressure?
Author: Cleaves M. Bennett MD FACP
Monday, January 07, 2008

Blood Pressure

Exercise lowers it!

Let me give you a word of warning here. Heavy weight lifting will raise your blood pressure, not lower it. As I said earlier, aerobic exercise is the kind of exercise you should be doing, not lifting heavy weights. The kinds of exercise that make you grunt and sweat and strain are not recommended, especially if you have high blood pressure already. On the other hand, light weights with high number of repetitions can be part of a well balanced fitness enhancing program. But it’s best to work with a trainer for a while if you are going to be lifting weights.

Even aerobic exercise may send your blood pressure up at first. That's why I recommend that if you have high blood pressure, particularly if it's moderate or severe, you should ask your doctor to give you a treadmill test and an exercise prescription before you start to exercise.

If you’ve been a sedentary slug, you’ll need to start out pretty slow. But over time regular exercise will become so natural for you that it will actually lower your pressure. See for yourself– check it before and after exercise—and watch the numbers come down. Sometimes it will be dramatically lower. I have seen people at the program I work with come in with high blood pressure and watched it drop to 90/60 at the end of the hour–long exercise program.

Exercise opens up the little arterioles all over the body, and it also tends to burn up a lot of the hormones that are produced by the stress response which raise the blood pressure. So the lowest blood pressure of your day may be in the fifteen minutes or half an hour after a good, exhausting exercise.

Pat, the lawyer friend and patient I told you about earlier, got a lot out of his exercise program. It appealed to him because it was something immediate and physical and real—he could do something—it was "manly" (in an old–fashioned sort of way) to sweat and breathe hard and get tired. I already told you his cholesterol fell a lot—he’d done a good job on the diet. And his blood pressure was pretty good too, considering how competitively he approached everything. Oh, it still bounced up sometimes, but on the average it was pretty good.

When it came to stress management, he was always a little skeptical about meditation and things like that. He did practice a little therapeutic avoidance, however. On his own initiative, he dropped out of trial law for a while and let his associates go into court for him instead. He took to wearing turtleneck sweaters and sports coats to the office, instead of the blue pin–striped three–piece suits he had always worn before. He looked happier and more relaxed, and the wrinkles in his forehead even started to soften a bit!

But he always thought he got the most out of exercise, and that's what he liked to talk about.

I laugh when I remember how he passed the FAA medical examination to renew his pilot's license. He got pretty uptight about it and postponed it several times, because he was afraid he'd have a relapse and his blood pressure would go up, and he'd flunk it.

I told him to go right after his daily run, when we knew his pressure was at its lowest point of the day. He did, and it worked. He ran his usual four or five miles, and then another seven miles, and went right over without even stopping for a shower! His pressure was very low because he was so relaxed and so exhausted by his run that his worries about passing the test just couldn't affect him at all.

Oh, his pulse rate was a little high and the doctor made a comment about it. But I told Pat not to worry; it was high because his body still had heat to dissipate after that near marathon endurance run. To celebrate his success, he took me out to lunch at a place where we both had to scramble a bit with the menu and special–order to stay on a healthy diet. Ah, that's America for you!

Other Benefits of Exercise

Your skeleton is a wonderful system that adapts to whatever you do with your life. If you need strong bones because you're exercising regularly, your bones will become strong. And on the other hand, if you're not exercising at all, your bones will become weak. A regular exercise program tends to strengthen your bones. And if you’re getting enough calcium in your diet and vitamin D from sunlight or diet, that exercise will prevent osteoporosis, the thinning out with aging that makes bones so brittle and easy to break.

Exercise also strengthens your muscles, particularly in your legs, back, and abdomen. It strengthens your breathing muscles so that you can breathe more easily, whatever you are doing. And remember to continue to practice belly breathing, if this is new to you, because using the diaphragm to expand your lungs during exercise (and even at rest) is a more efficient and effective way to bring oxygen into, and carry CO2 out of the body.

Exercise will tend to make the whole system that delivers oxygen to your organs and the cells of your tissues more efficient. It will help your tissues to receive more oxygen. It will stimulate the formation of enzymes in the muscles that facilitate the movement and use of oxygen.

Exercise tends to make your heart stronger. You will notice that as you get physically fitter your resting heart rate will fall, usually to a figure below 60 a minute.

Exercise tends to have a beneficial effect on arthritis, and particularly on the degenerative arthritis and stiffness that often accompany old age. I have seen people who were crippled with arthritis in the ankles, knees, and hips, and who could barely get around—and I have watched them go through a careful, gradual exercise program. They felt as if a miracle had happened. They lost their pain, and they could go places again. But with arthritis, once again, it's important that you cooperate with your physician and start out your exercise program carefully and gradually.

Exercise tends to promote the normal functioning of the bowels. I always tell my patients that I've never known a constipated runner. Somehow, in the jostling and vigorous movement of the abdominal muscles when you run, food and waste products are moved through the bowels, and so running turns out to be a cure for constipation. (You’ll notice that seasoned runners pick paths where there are toilets at regular intervals—they know from experience how important that is).

If you're a pretty sedentary person when you begin your exercise program, you may be surprised and delighted to notice that your appetite actually decreases at first. And that as you keep up with the program your appetite will be more closely related to your body's needs.

You'll become more responsive to what your body actually needs in terms of food, and less likely to eat out of boredom, or because you're "starved", or it seems like a good idea, or it's lunchtime.

One of the components of "hunger" is low blood sugar. And a very effective way to lower blood sugar, paradoxical though it sounds, is to eat sugar. While you're actually eating sweets, and right afterward, your blood sugar rises rapidly—but later on it plummets. And then look out. Because, when it falls that's when you feel hungry ("I'm starved!"), and you're likely to feel like snacking or eating a full meal.

Given the momentum of eating—that is, the likelihood that once we start eating we'll continue until all the food is finished—having your blood sugar drop can easily lead to an excessive intake of calories.

Here's the solution.

Exercise also raises blood sugar—by burning up stores of fat. So if, once or twice a day when you feel hungry, you were to walk briskly or jog say at lunchtime for example—you'd reduce your intake of calories, use up stored fat, lose weight, and eliminate one of the main forces that leads to compulsive eating.

Exercise will tend to promote the development of larger arteries, particularly the arteries that supply your muscles, lungs, and heart. And in some cases (we don't yet know how to make it happen every time) exercise will actually promote the development of additional circulation (collaterals) around blocked arteries, in the heart or legs for example.

Exercise is a wonderful cure for stress, for feeling frazzled and hassled and burned out, as Dr. William Whitmer points out in his book, Whitmer's Guide to Total Wellness.

You come home, you've had a struggle at the office, you fought the traffic all the way home, you're upset. Instead of sitting down with a beer and watching the bad news on TV, go out right now and exercise. Even if it's just a brisk walk, do something to burn up those stress chemicals in your blood.

If you find yourself getting hassled during the day, and you feel like having a drink at lunchtime, or you tend to overeat at lunch on days like this—take a brisk walk instead! Use part of your lunch break to burn up some of the nervous tension that's been building in you all morning! Try it. You'll have a happier afternoon.

Weight loss is another area in which exercise is important. You simply can't conquer obesity without a regular exercise program. Exercise is absolutely necessary in any program to produce permanent weight loss. (Coronary Artery Disease 2000:11:111–6)

Over a long time, exercise will actually remodel your body. People who sit around all the time and eat a lot develop fat, which functions as a cushion; while people who walk or run a lot need to be more streamlined. So exercise streamlines the body. It will use up your bulky fat stores, and your muscles and your bones will get heavier—your body will actually reshape itself to be more in line with your new lifestyle!

Exercise is also wonderful for dealing with sleep problems. Many people who have some form of insomnia are not regular exercisers, and most people who exercise regularly find it's much easier for them to get to sleep. I find that now I'm on a regular exercise program I sleep more deeply and just don't need as much sleep as I used to.

And exercise is the only thing that will really do the trick for people who are feeling tired and run down. The tonics they advertise on TV don't do it. But a regular exercise program will.

Some people who smoke, or don't get much exercise, or have high blood pressure, find their hearts beat a little irregularly.

These slightly irregular heartbeats are called premature ventricular contractions or PVC’s in medical terminology, though people often refer to them as "skipped beats." They may be harmless—but regular exercise will often clear them up in any case.

One other effect of exercise that you probably won't notice, but that will please your doctor very much, is that it tends to reduce the amount of LDL (bad) cholesterol and fat in your blood and also raise the percentage of HDL (good) cholesterol.

HDL’s are high–density lipoproteins, which scavenge the cholesterol in your arteries and bring it back to the liver to be disposed of. Regular exercise actually helps clean up your arteries. And that means that, in any program that's designed to prevent heart attacks, regular exercise is essential.

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