Exercise for Hypertension Patients

Exercise for Hypertension Patients

Hypertension is defined as having a systolic blood pressure equal to or above 140 mmHg and/or a diastolic blood pressure equal to or above 90 mmHg, or being on antihypertensive medication or having been informed by a healthcare professional on at least two occasions that blood pressure is elevated. Hypertension is classified into secondary hypertension and primary hypertension based on its underlying causes. Secondary hypertension, also known as secondary hypertensive disease, is caused by other medical conditions such as glomerulonephritis and pyelonephritis. In these cases, hypertension usually resolves once the underlying disease is treated. Secondary hypertension accounts for less than 10% of all hypertension cases. Primary hypertension, also known as essential hypertension, results from long-term increased peripheral vascular resistance, leading to arterial wall damage and subsequent arteriosclerosis. If primary hypertension coexists with risk factors such as hyperlipidemia, it accelerates the development of arterial sclerosis, leading to significant organ damage, including stroke, myocardial infarction, heart failure, and chronic kidney disease. Primary hypertension accounts for more than 90% of hypertension cases and is often referred to as the "silent killer" because patients are usually asymptomatic in the early stages, and by the time it is diagnosed, it may already have caused irreversible damage with high disability and mortality rates. Moreover, it places a heavy burden on healthcare and social resources for families and countries. Both domestic and international practices have proven that hypertension is a preventable and controllable disease. Lowering blood pressure levels in hypertensive patients can significantly reduce the incidence of stroke and heart disease, improve patients' quality of life, and effectively reduce the disease burden.

(1) Objectives of Exercise for Hypertension Patients

The goals of exercise for hypertension patients are to enhance the regulation of autonomic nervous function in the cerebral cortex, reduce sympathetic nervous excitability, increase vagal nerve excitability, alleviate small venule spasms, and lower blood pressure to a "normal" or "ideal" level. This helps reduce the risk of cardiovascular diseases, gradually reduce the dosage of antihypertensive medications, lower the tension in capillaries, arterioles, and small arteries, regulate blood circulation, and adjust the levels of vasoconstrictors and vasodilators in the blood to decrease vasoconstrictors and increase vasodilators. Exercise can also reduce patients' stress responses, inhibit mental and physical tension, and eliminate anxiety.

(2) Key Points for Exercise in Hypertension Patients

Firstly, different degrees of hypertension require different types and amounts of exercise. Exercise intensity should be strictly controlled, and patients can adjust and determine exercise intensity based on their physical condition, disease status, age, etc. Patients in Phase I hypertension can engage in normal physical exercise or moderate-intensity exercise; those in Phase II hypertension can participate in low-intensity exercise such as fitness aerobics, Tai Chi, walking, etc.; and those in Phase III hypertension can do qigong exercises and body massage. Patients with complications in Phase II and Phase III hypertension should avoid high-intensity competitive sports and static apnea exercises.

Secondly, before and after exercise, warm-up and relaxation activities should be done, medical supervision should be enhanced, and patients should observe changes in their physical conditions to avoid blindly pursuing a "suitable exercise heart rate." It is important to learn self-control. During exercise, avoid exercising within 1 hour after a meal, after drinking alcohol, or after bathing. Patients should also refrain from exercising if feeling fatigued, weak, or having a cold. In the presence of discomfort, obvious fatigue, or other abnormalities, exercise intensity should be immediately reduced, or exercise should be stopped.

Thirdly, hypertension treatment is a comprehensive process, including measures such as medication, care, diet, psychological therapy, and exercise therapy. Exercise therapy is only one component of this process. Therefore, sufficient sleep should be ensured, and other aspects such as diet control, stress relief, enhanced care, and timely medication should not be neglected. During exercise, the effects of medications on blood pressure and the cardiovascular system should be considered. Blood pressure should be regularly checked to observe and understand changes in blood pressure to provide a basis for revising exercise plans.

Fourthly, exercise must be consistent and persistent to ensure the therapeutic effect of exercise and ultimately achieve the goal of lowering blood pressure. Therefore, persistence in exercise is the key to achieving and maintaining the effect of lowering blood pressure and preventing and treating cardiovascular diseases. Whether it is exercise time or exercise volume, it should be gradually increased after the body adapts to the exercise, and exercise time and intensity should be increased gradually.

(3) Selection of Exercise for Hypertension Patients

Aerobic Exercise

The selection of exercise should primarily focus on aerobic exercises that lower peripheral vascular resistance, such as walking, jogging, cycling, and swimming. Elderly hypertension patients can choose to practice Tai Chi, qigong, and relaxation exercises. Patients can also select exercise activities based on their interests, aiming for full-body exercises that promote relaxation, have a rhythmic nature, and are easy to monitor.

Strength Training

Progressive strength exercises can effectively lower the resting systolic and diastolic blood pressure in patients and serve as an effective non-pharmacological intervention. Therefore, mild hypertensive patients and healthy elderly individuals are recommended to engage in cyclic strength exercises, such as using medium or low intensity to overcome their own body weight (push-ups, sit-ups, etc.) or using elastic bands for trunk and limb muscle stretching exercises.

Flexibility Exercise

Progressively stretch the body's various joints to gradually improve flexibility.