Lowering Blood Pressure with Exercise

How to lower blood pressure with exercise

In this article:

  • Noting the values of exercise
  • Getting started
  • Knowing your limits
  • Exercising for weight loss and strength
  • Lowering your blood pressure with alternative measures

Of course, you need to make up your mind to exercise and actually do the exercise to get the benefits, but the benefits of a regular exercise program can’t be denied.

Two significant effects are the following:

  • Exercise can lower blood pressure — especially for people who have high blood pressure.
  • Exercise causes weight reduction and weight loss maintenance, which also help to lower blood pressure.

In addition, an exercise test can help determine which people are likely to develop high blood pressure. People with an exaggerated rise in blood pressure during exercise are much more likely to develop sustained high blood pressure later in life. They need to be watched more carefully. 

Understanding the Benefits of Physical Activity

Exercise strengthens all the muscles involved in your body’s movement. If you walk or jog, you strengthen your leg muscles. If you lift packages, you strengthen your arm muscles. Whatever the exercise, your heart muscles become stronger. At the same time, your body opens up your arteries to allow for more flow of nutrients into the tissues. The combination of a stronger, more efficient heart and more open blood vessels leads to lower blood pressure.

Lowering your blood pressure is a good enough reason to make exercise an important part of your lifestyle, but if you need more, check out this list for additional benefits from exercise:

  • Improves your memory
  • Reduces the risk of breast cancer and large intestinal cancer
  • Lowers blood sugar, thus protecting you against diabetes
  • Increases energy level
  • Improves mood
  • Makes you sexier
  • Helps you sleep better
  • Strengthens your bones
  • Lowers bad cholesterol and raises good cholesterol

Preparing for Exercise

Take these three important steps before you begin an exercise program:

  1. Determine your current physical condition to decide what type of exercise program is right for your fitness level.
  2. Choose the exercises that you plan to make part of your program.
  3. Get the right equipment.

Checking your physical condition

When you know your beginning fitness level, you can chart your progress. One simple way to test your fitness level is to:

  1. Take your pulse.
  2. Walk a mile.
  3. Note how long it took you to walk and your pulse rate at the end of the mile.

The time and your pulse give you a baseline for comparison as you improve.

To take your pulse: With your palm upward, place your index and middle finger over the wrist artery that’s about 1⁄2 inch in from the outside of the wrist. (Don’t use your thumb to feel because it has its own pulse and can confuse your count.) Count the number of beats for 15 seconds and multiply by four to get your one-minute pulse rate. (If you can’t feel your pulse in the wrist, try feeling the pulse in your neck, where it’s much stronger.)

Write down the number before you forget it! You can do this simple test about once a month and you’ll be astounded at your progress as your pulse gets slower and slower — indicating a much more efficient heart.

If you haven’t exercised for many years, don’t start a program without some preparation. People over the age of 40 should talk to their doctor and have a physical examination. Your doctor may recommend an exercise electrocardiogram, better known as an exercise test or stress test. This test looks at the response of your heart to fairly vigorous exercise. If you get through an exercise electrocardiogram without problems such as chest pain, severe shortness of breath, or changes in your electrocardiogram, you’re probably in good enough shape to begin an exercise program.

Ask your doctor to help you map out an exercise plan that can strengthen your heart and prevent high blood pressure. If you already have high blood pressure, discuss a plan that can help lower your blood pressure to an agreeable level.

When you begin your exercise program, keep these facts in mind:

  • Start slowly and build up over time. You don’t need to rush to get to a certain level of exercise by a certain date. Gradually work your way along until you achieve your goal.
  • You don’t need to go farther and faster after you reach a level of fitness that affects your blood pressure. That desired fitness level may lower your blood pressure by as much as 10 millimeters of mercury systolic (see article 2 for more about blood pressure measurement), which is just as good as most pills can accomplish.

If you’re really enjoying the exercise and want to rev it up, that’s up to you — but going farther and faster won’t lower your blood pressure any more.

People with high blood pressure have a post-exercise fall in blood pressure that may last seven or eight hours. Therefore, daily exercise can have a much more profound effect on your blood pressure than exercising only three or four times a week. 

Choosing exercises

For maximum fitness, most exercise programs combine two types of exercises: aerobic and anaerobic.

Aerobic means with oxygen. During aerobic exercise, the body uses oxygen to help provide energy. Aerobic activity can be sustained for more than a few minutes, and it involves major groups of muscles (particularly the legs but also the arms if you can’t use your legs). Activities such as walking, running, cycling, tennis, basketball, and so forth make your heart pump faster during the exercise.

Anaerobic means without oxygen. Anaerobic exercises are very intense, so they can’t be sustained for very long. Examples are lifting heavy weights and doing the 100-yard dash. They depend on sources of energy that are already available (like glucose in your muscle).

Engaging in a regular aerobic exercise program can, over time, lower your blood pressure up to 10 millimeters of mercury systolic and enable you to get off a blood pressure medication. In contrast, anaerobic exercises, although great for increasing the strength of individual muscles, don’t go on long enough to improve heart function or lower your blood pressure. But a program of both aerobic and anaerobic exercises gives you the best of both worlds — lower blood pressure and stronger muscles. (See the “Exercising for Strength” section later in this chapter for practical anaerobic exercise ideas.)

Stepping up to a multilevel walking program

The range of aerobic exercise choices is limitless. Mix it up a bit. Play tennis several days a week and do something else, perhaps walking, the other days. Walking is the exercise that almost everybody can do; you don’t have to belong to a special club, and, unless you live in an area that has snow a good portion of the year, you can walk outside most any day — even in the rain. You can easily walk alone, but walking with a friend makes the activity more pleasant and also allows you to encourage each other to stay committed.

Table 1 outlines a walking program that starts slowly; most people can complete Level 1 without a great deal of difficulty. (If the distance is too great for you, begin with half the distance.) When you can accomplish the goals of one level once a day for seven days, you’re ready to move to the next level. If you did the test that I describe earlier in “Checking your physical condition,” you already know how fast you can walk a mile. Start at that level, not a slower one, and build from there. If you didn’t do a fitness test, walk a mile and check your time. Begin the seven days at that level.

Table 1 breaks the walking program into 15 levels so you can work your way up to a desired level of fitness to lower your blood pressure.

Table 1 Walking Program to Achieve Lower Blood Pressure
Level Distance in miles Time in minutes
1 1 30
2 1 28
3 1 26
4 1 24
5 1 22
6 1 20
7 11/2 32
8 11/2 31
9 11/2 30
10 11/2 29
11 11/2 28
12 11/2 27
13 11/2 26
14 11/2 25
15 11/2 24

Thirty minutes a day is the minimum recommended length of exercise. When you reach Level 15 (or 15⁄8 miles in 30 minutes), you can stay there permanently. It will make a significant difference in your blood pressure as well as other aspects of your health. Surely you can spare half an hour daily to make a huge impact on your health.

Walking 10,000 steps every day

An alternative to the 15-level program is to walk 10,000 steps a day, which may be easier because you get constant feedback. Use a pedometer, a device you wear on your waist, to count your steps. Keep track of your daily steps for a week to get your average daily steps. Then try to increase your steps by 500 daily. When you’ve gone seven days at this new level, go for another 500. Keep increasing until you’ve reached 10,000 steps a day.

At 10,000, you’re walking about five miles. “Impossible!” you say. Isn’t it amazing what you can do when you make up your mind? Pedometers are available at sports stores, but you can find some of the best and most reliable at www.accusplit.com. For more help with this program, go to www.thewalkingsite.com/10000steps.html. If you really want to turn your walking into fun and education, go to http://walking.about.com/cs/beginners/l/blwebwalkingadt.htm for the American Discovery Trail, a virtual tour across the country with links to all the interesting sights along the way. You can walk from Cape Henlopen State Park in Delaware to Point Reyes National Seashore in California by converting your daily steps to miles (simply eliminate the last two digits; for example, 10,000 steps becomes 100 miles). The Web site tells you what you see as you add miles each day. Who knows — you may decide to do it for real.

Choosing other aerobic activities

Walking is great exercise and certainly one of the simplest, but don’t feel like you have to walk to enjoy the pressure-lowering effects of exercise. If you prefer other types of aerobically effective activities, feel free! Just make sure you can do them and stick with them. Table 12-2 lists some of those activities. In addition, consider racquetball, squash, handball, rowing, judo, karate, social dancing, and singles tennis. People from different cultures may also have different exercises that they particularly like such as soccer, rugby, and cricket. What you do doesn’t really matter; but you have to do something.

Getting the right equipment

If you plan to engage in an exercise that may cause friction in your joints like walking and jogging, get the best footwear you can afford. Some of the sneakers available today seem awfully pricey, but when you consider what you save in the long run (pun intended) in health costs, then they’re well worth the price.

Try to find a store where the staff is knowledgeable about shoe needs, perhaps one that caters to runners and walkers. Make sure you have the right clothes for your exercise. Dressing in layers is a good idea because you can remove clothing as you heat up.

Some sports clothes are better than others because they sweat, allowing your perspiration to pass through and evaporate rather than sticking to your body. This process cools you off and helps you to feel less wet as you exercise. Polyesters work well, but cotton absorbs the moisture and holds it against your skin. For cooler weather, choose an outer layer that repels wind and rain but allows sweat to pass through. If you choose to do plenty of biking, make sure you have a bike suitable for the terrain. Bikes that are good for flat streets are very different from mountain bikes. Even the tires are different. If you want to limit yourself to an indoor stationary cycle, make sure the quality is good.

Knowing the Right Levels of Exercise

Want to know whether your exercise is making a difference in your fitness? You could do a fitness test each time you exercise. But because you don’t make huge strides each time, you’d definitely be disappointed. In the past, fitness advisors suggested measuring your heart rate during exercise. If your pulse was in the training range, it was fast enough to improve your fitness but not too fast to overexert your heart. But today’s research shows that the concept of the training range is probably not useful.

Today’s research shows that people can exercise with a faster pulse than their training range and benefit from it by rating their physical activity of choice according to the Perceived Exertion Scale (which compares favorably with the pulse and consumption of oxygen, two measures known to correlate with fitness). The scale helps people determine whether an activity is making a difference in their fitness, and these are the basics:

  • You rate the degree of your exertion while performing a certain activity from very, very light to very, very hard — according to your personal physical ability level.
  • In-between levels are very light, fairly light, somewhat hard, hard, very hard, and extremely hard.
    • Very light is like walking slowly for several minutes.
    • Fairly light means you’re breathing harder but can continue.
    • Somewhat hard exercise is getting a little difficult but still feels okay to continue.
    • Hard means you’re starting to have trouble breathing; speaking is difficult.
    • Very hard exercise is difficult to continue, so you have to push yourself; you’re very tired and have trouble talking comfortably.
    • Extremely hard exercise is the most difficult you have ever tried.
  • The very hard level of exercise is most beneficial.
  • As your fitness level increases, your definition of very hard changes. What was once very hard may become fairly light.

Exercise is beneficial for every stage of high blood pressure. However, doctors generally recommend that people with blood pressure in the higher stage 2 (greater than 160 systolic and 100 diastolic) exercise at a slightly lower level than stage 1 patients. Referring to the Perceived Exertion Scale, stage 2 patients should work at the somewhat hard instead of the very hard level.

To learn more about the Perceived Exertion Scale, check out www.cdc.gov/nccdphp/dnpa/physical/measuring/perceived_exertion.htm and www.pponline.co.uk/encyc/1020.htm on the Web.

Exercising to Lose Weight

Exercise can help you lose weight, but you need to exercise at least 90 minutes six days a week. (To maintain a weight loss, you need to do 60 minutes daily; to get into good physical shape and have an effect on your blood pres- sure, you need at least 30 minutes a day.)

The exercise doesn’t have to be continuous. Three ten-minute sessions are as good as 30 uninterrupted minutes.

A kilocalorie is the amount of energy needed to raise the temperature of a kilogram of water 1 degree centigrade, and a pound of fat contains 3,500 kilocalories (kcals). So, to lose a pound of fat, you must use (burn, exercise, whatever) at least 3,500 kilocalories more than you eat. For example, if you eat 2,000 kilocalories each day to maintain your weight, you can lose 1 pound in seven days by using 500 kilocalories more each day than usual (500 × 7 = 3,500). Doing only 250 kilocalories of extra exercise takes 14 days to lose the same pound. Walking an hour each day burns 4 kilocalories per minute, 240 kilocalories in all.

Table 12-2 shows the number of kilocalories that you burn doing several different kinds of exercise for 30, 45, or 60 minutes.

Activity 30 minutes 45 minutes  60 minutes
Doubles tennis 85 128 170
Walking a 20 min mile on a flat surface 120 180 240
Water aerobics 140 210 280
Walking a 15 min mile on a flat surface 146 219 292
Walking a 20 min mile uphill 162 243 324
Golf (carrying your bag) 174 261 348
Walking a 15 min mile uphill 206 309 412
Swimming 250 375 500
Basketball 282 423 564
Cycling (12 mph) 283 425 566
Cross-country skiing  291 438 583
Aerobic dance 342 513 684
Running 10 min mile 365 549 732

Exercising for Strength

A complete exercise program includes aerobic exercises to lower your blood pressure and anaerobic exercises to strengthen your muscles. (See the earlier section “Choosing exercises” for more about aerobic activities.) Strengthening your muscles allows you to do more aerobic exercise as well as improve your balance. To add an anaerobic element to your workout, get yourself some dumbbells of various weights and some barbells, to which you can add more weight as you get stronger. Use dumbbells of no more than 5 to 10 pounds when you start. In just a few days, those weights will feel light. 

If you have high blood pressure, use weights that allow you to do many repetitions of an exercise instead of a few extreme lifts with very large weights. Extreme lifting may suddenly raise your blood pressure to unacceptable levels.

A weight-lifting program requires no more than 15 minutes of your time about five days a week. Do it for two days, skip a day, do it for another three days, skip a day, then back to two days, and so on. These breaks allow your muscles to recover between exercise workouts.

If you stick to the simple program in the following sections, you’ll be amazed and delighted at the rapid progress you make in body strength, increased fitness, and increased self-assurance. Just be sure to increase the weights as they become easier to lift so you continue reaping the rewards. Among other benefits, weight lifting helps you:

  • Keep your bones stronger
  • Prevent injuries by improving balance
  • Look better
  • Speed up your metabolism

You can expect to increase your muscle strength 7 to 40 percent with ten weeks of training.

Upper-body exercises

The following list describes seven exercises that you can do in 15 minutes to improve your upper-body strength. Simply do 15 repetitions of each exercise and move on to the next. Each series of 15 repetitions of seven exercises is called a circuit. Do two circuits without stopping each time that you exercise. Start with an amount of weight that allows you to complete the 15 repetitions. If you can’t do 15, you’re using too much weight and overexerting yourself.

  • Shoulder press: Stand with your feet shoulder-width apart and knees slightly bent. With dumbbells in each hand, start with your hands next to your shoulders facing inward. Raise the dumbbells over your head until your arms are straight. Bring the weights back down to the starting position, palms facing each other.
  • Lateral raise: Hold a dumbbell in each hand by your sides, palms facing each other. Raise the dumbbells out to the sides, keeping your arms straight (but don’t lock your elbows) and your palms facing the floor, until they’re above your head. Return them to the starting position.
  • Bent-over rowing: Bend from the waist, keeping your knees slightly bent, until your upper body is parallel with the floor. With a dumbbell in each hand and your arms hanging straight down, slowly raise the dumb- bells out to the side until they’re in line with your shoulders. Lower them again.
  • Good mornings: Stand straight, holding a single dumbbell with both hands over your head. Keeping your arms straight over your head, bend from the waist until your torso and arms are parallel with the floor. Then raise yourself to the starting point.
  • Flys: Lie on your back with one dumbbell in each hand and your arms opened out to each side at shoulder height. Slowly raise the dumbbells in over your body until they touch above your chest. Slowly lower them back to the starting position.
  • Pullovers: Lie on your back with your knees bent, holding one dumbbell with both hands above your chest. Lower the dumbbell back over your head until it touches the floor. Then raise it back over your chest.
  • Curls: Stand straight, holding a barbell in each hand in front of you. With your palms facing up, slowly bend your elbows until your hands are shoulder height. Lower them back slowly to the starting position.

Evaluating the strength of your upper and lower body

Push-ups are a good way to evaluate your 1. Stand up straight with your arms by your upper-body strength. To do a push-up: sides and legs about shoulder-width apart. 1. Lie face down on the floor with your palms 2. Begin to bend your knees as you raise about shoulder-width apart. your arms to a horizontal position at your sides. 2. Push yourself up off the floor, straightening your arms and keeping your back and legs straight. 3. When your thighs are parallel with the ground, go back up again. 3. Lower yourself until your chest just touches 4. Continue Steps 2 and 3 until you grow too the floor, but don’t let your weight rest on tired to do any more, keeping track of how the floor. many you can do. 4. Continue Steps 2 and 3 until you grow too Save these numbers for future comparison. tired to do any more, keeping track of how Test yourself at intervals of four to six weeks to many you can do. keep track of your progress and to keep your- self motivated in your exercise program. Squats are good evaluators of your lower-body strength. To do a squat:

Leg-strengthening exercises

A couple of standard exercises for strengthening leg muscles, repeated 15 times each for two sets, include the following:

  • Lunge: Stand straight with your feet about shoulder-width apart. Hold a light dumbbell in each hand, palms facing your body. Take a long step forward with the right foot and bend the right leg until your thigh is par- allel with the ground. Hold the position a second, and then step back and straighten your leg. Lunge forward with the other leg.
  • Squat: Stand straight with your feet hip-width apart. Place a barbell containing light weights behind your neck and hold it with your hands. Bend your knees slowly and squat until your thighs are parallel with the ground. Pause, and then rise to the standing position.

Lowering Your Blood Pressure with Alternative Therapies

Although aerobic exercise is extremely helpful for lowering blood pressure, other disciplines (alternative therapies) can help accomplish this goal as well. When combined with exercise, the result can be significant. I can’t vouch for the value of each form for treating high blood pressure, but people can follow many different paths toward controlling their blood pressure. Perhaps one of these methods will appeal to you, and you can utilize it to save yourself from years of medical problems and expenses related to high blood pressure (not to mention all the other diseases waiting out there for patients with high blood pressure).

Yoga, meditation, hypnosis, and biofeedback are the most useful forms of alternative therapy for high blood pressure, but by no means are they the only forms. Holistic Online (www.holisticonline.com) lists no fewer than 20 different forms of alternative medicine. You may want to consider trying one or several of these practices. (They have some overlap in their effects, but each one is distinctive enough to have a following of devotees.)


Yoga is a series of postures and breathing exercises developed in India over 5,000 years ago as a way to achieve union (yoga) with the divine consciousness. Today, people often practice yoga as a way of improving their health and well-being without putting an emphasis on yoga’s religious side.

Yoga attempts to unite your body and your mind so your mind can function better in a more healthy body. Numerous studies have shown that yoga can lower blood pressure. A July 2006 article in the Clinical Journal of Sports Medicine points out the positive effect of yoga on blood pressure. This effect persists as long as the practice continues, and it often disappears if the individual stops practicing yoga.

Over its 5,000-years existence, yoga has evolved in many directions as teach- ers developed their different philosophies. As a result, yoga has eight main branches. Hatha yoga, the most popular branch, emphasizes physical fitness more than the others do. But this branch subscribes to plenty of meditation and spiritualism as well. An excellent source of information about all aspects of yoga is Yoga For Dummies by Georg Feuerstein and Larry Payne (Wiley). I highly recommend it. The Internet also offers many excellent yoga sites. The following are two of the best:

  • The Yoga Site (www.yogasite.com) can answer all your questions and direct you to many other useful sites.
  • The Yoga Journal (www.yogajournal.com) provides numerous articles concerning the world of yoga.


Meditation involves concentrating on an object, a sound, a word, or the breath in order to diminish random thoughts. The result is a calmer, more peaceful mind. Meditation doesn’t involve specific body postures like yoga does, but some aspects of yoga involve meditation, particularly the aware- ness of the breathing.

Meditation may be the best studied of the various forms of relaxation. Articles in the May 2005 American Journal of Hypertension and the January 2005 American Journal of Cardiology compare meditation with other forms of relaxation and find that the effect of meditation is significant in lowering blood pressure, much better than muscle relaxation and mental relaxation. Many clinical studies have shown that meditation can lower blood pressure and keep it down as long as the practice is continued. Just like yoga, meditation has gone in different directions over the years. The most popular form is Transcendental Meditation. Some of the best Internet resources on meditation are the following:

  • Learning Meditation (www.learningmeditation.com) is an award- winning site that explains meditation and how to use it in your daily life to find more calm and serenity. The author of this site actually prefers the term conscious relaxation or chosen relaxation to meditation. The site is well done, and I highly recommend it.
  • Holistic Online describes just about every kind of alternative therapy that exists, including meditation and even humor therapy. If meditation isn’t what you’re looking for, the site probably has something else that you can get into.


Hypnosis is a form of guided meditation (guided by another person or one- self) that slows down the brain and allows the hypnotized person to respond, within limitations, to the suggestions of the hypnotist. The definition often describes a sleeplike state, but practitioners insist that the hypnotized person isn’t asleep because she can hear and respond.

Note: A hypnotized person won’t do anything she doesn’t want to do. Studies show that hypnosis can lower mildly elevated blood pressure when appropriate relaxation instructions are given. People can hypnotize them- selves and control blood pressure effectively. You can find some excellent information on hypnosis on the Internet (what a surprise!). The following Web sites appear to have some very useful and valid information:

  • Hypnosis.com (www.hypnosis.com) has frequently asked questions that provide a clear explanation of hypnosis and what it can do for you. It clears up many myths about this useful therapy, particularly the myth that, under its influence, you can be induced to do something you would never do ordinarily.
  • The American Society of Clinical Hypnosis (www.asch.net) can help you find a therapist, and it explains a hypnotist’s certification. The site directs you to videos and books that help you get a clearer picture of hypnosis.


Biofeedback is a technique developed in the late 1960s in which you train your-self to alter an involuntary function (like heart rate, body temperature, or in your case, blood pressure) with the aid of a biofeedback machine. (Biofeedback machines detect a person’s internal bodily functions so the functions can be altered.) For example, one biofeedback machine picks up electrical signals from mus- cles and translates them into a flashing light. In order to reduce the tension in her muscles, the person using the machine first figures out how to slow down the flashes of light. After a while, she no longer needs the machine to relax; she simply uses the methods she discovered with the machine. Various kinds of equipment are available for biofeedback, and numerous Internet sites can help you find them. One of these sites is the Holistic Online site (www.holisticonline.com), which I list earlier in the “Meditation” section. A couple of other valuable sites are as follows:

  • The Association for Applied Psychophysiology and Biofeedback (www.aapb.org) contains answers to your questions as well as a list of practitioners, a bookstore for relevant books, and links to more information. 
  • The Biofeedback Network (www.biofeedback.net) is an online source for equipment, information, links, practitioners, and biofeedback centers. Its mission is to provide “Quality On-line Biofeedback Resources to the world biofeedback community.” That community may include you.