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Lowering Your Blood Pressure with Lifestyle Medicine

Updated: Feb 24, 2023

High blood pressure (BP) or hypertension is the most common costly but modifiable major risk factor for the development of cardiovascular disease and premature death that affects 47% of the U.S. adult population.

The American Heart Association (AHA) reinforces physical activity as a critical component of first-line treatment for individuals with mild- to moderate-risk for high blood pressure (BP). In addition, individuals with elevated BP (systolic 120 to 129 and diastolic less than 80) are encouraged to self-measure BP in the home to (a) confirm a diagnosis of hypertension, (b) rule out white-coat hypertension and (c) evaluate the treatment response of interventions such as exercise.

Just the act of BP self-monitoring is associated with improved BP control, but when performed in conjunction with co-interventions (e.g., education, clinician involvement, and lifestyle modification) translates to superior BP reductions than self-monitoring alone. 

Healthcare providers often limited to give initial and/or ongoing behavioral counseling for interventions like exercise or BP self-monitoring.

The result is often a very overwhelmed patient who has just been told they have 12 weeks to lower their BP on their own but with no clue where to begin. How much exercise is enough? What BP monitor should I buy? How often should I take my BP? Should I be recording all this data somewhere? 

After 12 weeks, the same patient returns for a follow-up visit clutching a crumpled piece of paper with a few BP values scribbled on it, with no corresponding date or documentation of physical activity, rendering this data difficult to make any sense of. Lifestyle intervention never stood a chance!  

Currently, there are few resources for the co-implementation of a structured BP self-monitoring and exercise program. Your personal trainer can help!

Exercise professionals are well positioned to serve as a trusted partner in care to unlock the value of patient-generated data into actionable insights that facilitate guideline-directed care that includes behavior-change that includes lifestyle intervention for clients with high blood pressure.

AHA guidelines recommend a self-measured BP monitoring of 2 measurements taken at least 1 min apart in the morning and evening (i.e., 4 readings per day) optimally for 7 days (i.e., 28 readings total) with a minimum of 3 days (i.e., 12 readings total).

Record time of day, exercise, medication use and other factors that may be useful for interpretation.

Ask you fitness professional for a Blood Pressure Tracking Form

In addition to daily BP assessment, patients can be encouraged to measure BP before and after an exercise session. Self-monitoring of BP before and after an exercise session has the potential to provide immediate feedback that BP is lower following exercise (and for some time after), allowing a you to link your exercise behavior with the positive health outcome of lower BP as a result of exercise.

Your personal trainer is able to provide you with appropriate guidelines and an Exercise Tracking Form so that you can document your activities and present this to your healthcare provider for your 12-week follow-up.

Moderate intensity exercise is recommended and may include aerobic exercise such as walking, cycling, swimming, resistance training exercise to strengthen muscles and bones, as well as neuromotor and flexibility exercises depending on personal preference or wellness goal.

Individuals with hypertension are encouraged to engage in ≥20 – 30 min of low, moderate, or vigorous intensity exercise on most, preferably all, days of the week to total ≥90 to 150+ min per week of continuous or accumulated exercise of any duration

Your personal trainer can provide specific guidelines and an exercise plan for the 12-week time frame that includes type of exercise, duration and intensity that is appropriate for your fitness level.

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