[World Hypertension Day] Don’t be afraid of hypertension, exercise properly to overcome it

Hypertension is a common chronic disease. The public is generally aware of the common sense of eating a light diet, controlling weight, and taking medicine regularly, but not many people know whether hypertensive patients need to exercise and how to exercise. Reasonable exercise has a positive effect on the health of hypertensive patients. Today, let's take a look at how hypertensive patients should exercise reasonably!

Hypertension refers to systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg without the use of antihypertensive drugs. Hypertension often coexists with other risk factors such as cardiovascular disease and diabetes, and is an important risk factor for cardiovascular and cerebrovascular diseases. Before patients receive drug treatment or formulate exercise prescriptions, we should conduct hypertension risk stratification for hypertensive patients in order to better formulate reasonable exercise training.

Which patients with hypertension are suitable for exercise?

People with hypertension who are suitable for exercise: those with critical blood pressure (140/90 mmHg) or in the low-risk group; those with hypertension who are receiving medication and have relatively stable blood pressure control and have no contraindications to exercise (the judgment of the risk level can be made by referring to Appendix 1 or consulting a specialist).

Appendix 1. Hypertension risk stratification (ISH2020)

People with hypertension who should not exercise: those with blood pressure of 180/110mmHg or 200/100mmHg at rest; those with retinal or renal changes, or significant left ventricular hypertrophy, unstable angina, cerebral ischemia or uncontrolled heart failure; those with blood pressure greater than 225/100mmHg or 220/110mmHg during exercise, or those who experience symptoms of angina or cerebral ischemia caused by exercise; those who have complications of antihypertensive drugs such as hypotension, bradycardia, muscle weakness, bronchial asthma, etc. should absolutely not exercise.

How should patients with hypertension exercise?

Patients with hypertension can choose from three types of exercise: aerobic training, resistance training and relaxation training. It is best to organically combine the three types of exercise.

Aerobic training can not only help the body lose weight and relieve stress, but also enhance the heart's reserve capacity and lower blood pressure. Aerobic training generally takes the form of walking, jogging, swimming, cycling, going up and down stairs, square dancing, etc., and you can also choose small ball sports such as table tennis and badminton. Patients can choose a sport that is easy to stick to and not prone to causing secondary damage to the body according to their personal preferences. For example, in life, for patients with knee arthritis, we should try to choose exercises that reduce excessive flexion and extension of the knee joint, such as swimming, and avoid mountain climbing, going up and down stairs, jogging and other sports that are harmful to the knee joint.

Generally, warm up for 5-10 minutes first, then start aerobic exercise. Choose the appropriate project according to your own situation, 30-40 minutes each time, generally not more than 1 hour, and relax after exercise (stretch tense muscles), generally 3-4 times/week. If your physical condition allows, you should try to reach the target heart rate (target heart rate = maximum heart rate × 70%, maximum heart rate = 220-age). During exercise, you should learn to monitor your own tolerance level - self-perceived exertion level assessment RPE (see Table 2) to find the exercise intensity that suits you. The exercise intensity is generally below moderate, and it is appropriate not to cause obvious discomfort and excessive fatigue. The specific scale of self-perceived exertion used for exercise intensity is as follows. It is recommended to control it at RPE12-14. If there are other complications, pay special attention to monitoring the corresponding indicators. If you feel uncomfortable, stop in time and seek help from professionals.

Table 2 Rated Perceived Exertion (RPE)

Resistance strength training can improve the patient's muscle strength, improve joint stability, and prevent joint damage. Generally, dumbbells, sandbags, elastic bands, etc. can be used as resistance sources for strength training of the upper limbs, leg muscles, and core muscles. It is recommended that patients choose exercise methods according to their personal preferences. Training should start with a small weight. If dumbbells are used, the initial setting can be 2.5kg (based on your tolerance), and the intensity can be increased step by step. Pay attention to breathing adjustments during exercise. Generally, exhale when exerting force and inhale when relaxing. Do not hold your breath. Warm up for 5 minutes before exercise, and stretch and relax for 5 minutes after exercise. Train each muscle group 2 to 3 sets, repeat 10 to 15 times per set, at a medium speed, rest for 1 to 2 minutes between sets, and generally do it 3 to 4 times a week. The following introduces the simple and easy operation method of resistance strength training with dumbbells and elastic bands:

Dumbbell elbow curls

Dumbbell shoulder external rotation exercise

Dumbbell Shoulder Abduction Exercise

Dumbbell shoulder bend exercise

Elastic band hip abduction exercise

Elastic band hip adduction training

The purpose of relaxation training is to relax tense muscles and emotions, and ultimately achieve full body and mind relaxation. Middle-aged and elderly people can choose relaxation training such as Tai Chi, breathing training, and muscle stretching. Abdominal breathing is common in breathing training. The key points of abdominal breathing: the belly bulges when you take a deep breath; the belly sinks when you exhale slowly. Muscle stretching is generally performed before and after aerobic or resistance training. Stretching muscles before training can reduce or avoid injuries caused by sudden muscle force during exercise. Stretching after exercise can relieve muscle tension, promote muscle length recovery, and maintain joint flexibility. The time should not be too long, generally about 30 seconds for each movement.

What are the precautions for patients with hypertension when exercising?

① Monitor blood pressure before and during exercise, have regular follow-up checkups at the hospital, and implement exercise plans based on a full understanding of the patient's condition and contraindications to exercise. For patients with more serious conditions (such as those with coronary heart disease, cerebrovascular disease, etc.), it is recommended that the exercise be carried out under the guidance or supervision of a specialist.

② Exercise should be carried out in a gradual manner, with a moderate to low intensity, so as not to cause fatigue and obvious discomfort symptoms such as headache, dizziness, palpitation, chest tightness, shortness of breath, chest pain, etc. If the above symptoms occur during exercise, it means that the exercise intensity is too high and you should rest immediately.

③ While exercising, you should also pay attention to a low-salt, low-fat diet and eat more fresh fruits and vegetables; patients with hypertension at medium risk or above should exercise on the basis of medication control and blood pressure reaching the standard; for patients with overweight and obesity, it is recommended to carry out a weight loss plan at the same time, and if necessary, consider adding weight loss drugs under the guidance of a physician.

④ Relax and avoid tension during exercise; do not overwork or pursue goals excessively; pay attention to safety precautions during exercise to avoid secondary injuries.

In this era of advocating national fitness, the role of exercise is self-evident. The key is that everyone needs to take action. At the same time, don't be afraid of high blood pressure. Let us overcome it through reasonable exercise.