Aerobic exercise for heart health
The message is loud and clear: Regular exercise is good for your health. But is all exercise created equal when it comes to your heart health and high blood pressure? Not necessarily, says Luke Laffin, MD, a cardiologist at Cleveland Clinic in Ohio.
Aerobic exercises—such as brisk walking, jogging, or using a spin bike or elliptical trainer—are the best exercises you can do if you have high blood pressure. That’s not to say that other types of exercise aren’t beneficial. It’s just that that aerobic activity gets your heart rate up and has the most powerful blood pressure-lowering effects, Dr. Laffin says.
Here’s everything you need to know about high blood pressure and exercise, including the best exercises recommended by cardiologists and how to go at your own speed. (Psst, here are 13 things cardiologists won’t tell you.)
What is high blood pressure?
High blood pressure is a major risk factor for heart attack and stroke. It rarely causes symptoms so the only way to tell if you have high blood pressure—and get ahead of its consequences—is to know your numbers.
Blood pressure is the force of blood flowing through your blood vessels. Your doctor should measure your blood pressure as part of your wellness exam. You can also monitor it at home with these best at-home blood pressure monitors.
A normal blood pressure reading is less than 120/80 mm Hg, according to the American Heart Association (AHA). Systolic blood pressure, the upper number, refers to how much force your blood is exerting in your arteries when your heart beats. In contrast, diastolic blood pressure, the lower number, is the force in your arteries when your heart is at rest.
High blood pressure (aka hypertension) is diagnosed in stages. Stage 1 hypertension is a blood pressure reading of 130/80 mm Hg or higher. Stage 2 hypertension is blood pressure above 140/90 mm Hg. It’s important to know that blood pressure doesn’t need to be extremely high to cause health problems.
Being overweight or obese is one of the known risk factors for high blood pressure. Others include eating an unhealthy diet that is loaded with salt, not exercising regularly, smoking, and/or drinking too much alcohol.
Exercise for high blood pressure
Exercise is a big part of a heart-healthy lifestyle. The AHA suggests aiming for at least 150 minutes of moderate aerobic physical activity a week. “This is the minimum,” Dr. Laffin says.
A study published in 2019 in the Journal of Hypertension and Cardiology suggests that even a small reduction in blood pressure may be enough to translate into a significant reduction in the incidence of heart attacks and strokes.
Ideally, you want to space activity out over the course of a week, with 30 minutes or so a day on most days, Dr. Laffin says. But “there is evidence that being a weekend warrior is as beneficial or almost as beneficial as exercising five times a week for 30 minutes,” he explains. (Also, keep in mind that yoga and aerobic exercise can reduce your risk of heart disease.)
In a study, published in a 2019 issue of Hypertension, walking on the treadmill for 30 minutes in the morning lowered average blood pressure among older, overweight or obese adults. For the women in the study, taking three-minute breaks from sitting every half hour throughout the day enhanced the beneficial effects of the morning walks on systolic blood pressure. (Also, check out these tips to lower blood pressure reading.)
“The best thing you can do to lower your blood pressure is more aerobic exercise,” says Mike Farbaniec, MD, a cardiologist at Penn State Health Milton S. Hershey Medical Center in Pennsylvania. “This can be as simple as taking a brisk walk.”
The best thing about a walking program is that you can do it anywhere. You don’t need much to get started—just a good pair of walking shoes and perhaps a pedometer or step-tracking app.
And every step makes a difference, according to research presented at the 2020 American College of Cardiology’s Annual Scientific Session. Participants’ systolic blood pressure was about 0.45 points lower for every 1,000 steps they took each day. The researchers estimate that a person taking 10,000 steps daily would have a systolic blood pressure that’s 2.25 points lower than that of a person taking just 5,000 steps a day. (Here’s how to walk more steps in a day.)
Exercise packs a four-way punch against diabetes: It helps you lose weight, shrinks abdominal fat, makes your muscles “suck up” more sugar from your blood, and increases the body’s sensitivity to insulin. Need more convincing? Researchers found 10 science-backed reasons diabetics should work out. But you don’t have to become an Olympic sprinter to reap these benefits. Just 30 minutes of moderate-intensity aerobic activity (like brisk walking) five days a week can make a difference, according to the American Diabetes Association (ADA).
How to prevent diabetes
Start with short walks, or walk just a few days of the week, then build up gradually from there. Try pacing in your house while talking on the phone, parking far from the entrance at work or at the store, or just marching in place in your living room during TV commercials. You start reaping in the benefits after just 15 minutes of walking. Your goal is to battle “sitting disease.” Research published in a 2016 issue of Diabetes Care showed that, for adults with type 2 diabetes, breaking up bouts of sitting every half hour with three minutes’ worth of movement—a leisurely walk or simple resistance moves such as standing push-ups against a wall or counter—improves blood glucose levels, compared with uninterrupted sitting.
Other types of aerobic exercise
Swimming, biking, jumping rope, and rowing are also great options. Whatever type of aerobic activity you choose, it will help you keep your weight down, strengthen your heart, and lower your stress levels. (Here are the best exercise bikes for an at-home workout.)
High stress, over time, can increase blood pressure levels.
“You should start to see a benefit in the first couple of weeks,” says Dr. Farbaniec.
Important to note: When you exercise, your blood pressure rises along with your heart rate. This is normal and expected, Dr. Farbaniec explains. After your exercise session is over, your blood pressure will gradually return to normal. The benefits from exercise continue for as long as you keep up your exercise routine, he adds.
It’s OK to mix in some strength training at least two days each week, the AHA notes. But there is a caveat, says Dr. Farbaniec. “The transient increase in blood pressure when lifting weights can be dangerous if you don’t know that you have high blood pressure,” he says. This increase can be dramatic depending on how much weight you lift.
If you are planning to start an intense weight-lifting regimen, get your doctor’s approval first to make sure there aren’t any reasons you shouldn’t start the program and to know your baseline blood pressure, he says.
“Aerobic exercise plays a much bigger role in blood pressure control,” says Dr. Farbaniec. “Aerobic exercise increases the efficiency of the cardiovascular system by conditioning your heart to beat more efficiently so you can get adequate blood flow at lower blood pressures. This also, in time, helps muscles use the oxygen more efficiently.
“Although your blood pressure increases during aerobic exercise, the overall outcome ends up being a lower resting blood pressure because of this improved efficiency,” he adds.
More than exercise
Exercise is not a replacement for medication. If you need drugs to lower your blood pressure, it’s important to continue taking your medication as directed, Dr. Farbaniec says.
And while exercise is beneficial, it must be combined with other lifestyle habits. Those include following a healthy low-salt diet, maintaining a healthy weight, giving up cigarettes if you smoke, and limiting alcohol to one drink per day (for women) or two per day (for men) if you drink. All of these really have an impact on your heart health, says Dr. Farbaniec.
(Here are 31 things you can do to avoid high blood pressure.)
The last word
Exercise provides a number of health benefits. When it comes to high blood pressure, aerobic activity—such as brisk walking, jogging, or using an elliptical trainer—is your best bet. If you want to add strength training to your routine to build muscle, make sure your blood pressure is in the normal range and get the green light from your doctor.
Next, learn about the health dangers of even slightly high blood pressure.
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