If you train clients with hypertension, you’ll want to check out the new position stand of the American College of Sports Medicine (ACSM) on “Exercise and Hypertension.” (It replaces ACSM’s 1993 position stand “Physical Activity, Physical Fitness, and Hypertension.”) ACSM’s latest stand views exercise as a cornerstone therapy for the primary prevention, treatment and control of the disease. Adults with hypertension are advised to perform at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week, but are also advised that they should be regularly evaluated, treated and monitored.

Trainers who have clients with hypertension should keep in mind the following considerations:

  • The type, frequency and duration of activity are
    important. People with hypertension should
    exercise daily for 30 minutes or more at a
    moderate level to gain health benefits.
  • People using medications such as beta-blockers
    should be alert to signs of heat illness when
    exercising. Some medications, including diuretics,
    impair the body’s ability to regulate temperature.
  • People with hypertension should extend the
    cool-down period of the workout.
  • Antihypertensives—such as alpha-blockers,
    calcium channel blockers and vasodilators—
    may cause blood pressure to lower too much
    if exercise ends abruptly.
  • Overweight and obese adults with hypertension
    should combine regular exercise and weight
    loss to effectively lower resting blood pressure.
  • Evaluation and clearance by a physician are
    necessary prior to beginning an exercise program
    for those with severe or uncontrolled blood
    pressure. A lower-intensity training program
    should be used for higher-risk patients (such as
    those with coronary artery disease or chronic
    heart failure).
    ACSM also suggests that promoting the blood-pressure-lowering effects of single exercise sessions may be the best way to motivate these clients to exercise. For more information see www.acsm.org or the March 2004 issue of Medicine & Science in Sports & Exercise.