Personal Training Guide for Clients with Hypertension

Hypertension is a serious chronic illness. Known as a silent disease, high blood pressure doesn't really cause symptoms, but its complications can be serious and even fatal. Heart disease and stroke are leading causes of death in the U.S., and hypertension contributes to both.

Along with a healthy diet, not smoking, and limiting stress, exercise is one of the best lifestyle habits for preventing and even managing hypertension. If you have clients with chronic high blood pressure, make sure they see their doctors to make sure training is okay. If it is, there are several things to consider when planning an exercise program.

About High Blood Pressure

Hypertension is chronically high blood pressure. If your blood pressure rises occasionally—due to exertion, stress, or some other factor—it should return to normal quickly. It's only hypertension when blood pressure stays high most of the time.

Blood pressure readings higher than 130/80 can be considered stage 1 hypertension. Chronic high blood pressure puts strain on the heart, causing it to work harder. Over time, and without treatment, this can lead to hardened and scarred arteries and a significantly increased risk for heart attack and stroke.

According to the Centers for Disease Control and Prevention, almost half of American adults have hypertension. Only 25% of people with hypertension are managing it. Nearly 500,000 deaths in 2018 in the U.S. were at least partly attributed to hypertension.

Exercise and Hypertension

The consequences of living with untreated high blood pressure are serious. Many people need medication to control it, but exercise can also be helpful. In fact, some people are able to lower blood pressure and manage hypertension through exercise and lifestyle changes without medication.

How Exercise Lowers Blood Pressure

Exercise can both reduce the risk of hypertension and be used to manage it. The most direct way that exercise helps is by strengthening the heart. A stronger heart pumps blood more efficiently, reducing pressure on blood vessels.

Another factor is weight. Being overweight or obese is a major risk factor for hypertension. Regular physical activity can help a client lose weight or maintain a healthy weight. This, in turn, lowers blood pressure. Exercise can also reduce stress, another risk factor.

Cautions for Personal Training Hypertensive Clients

As a personal trainer, you're knowledgeable about a lot of medical and health topics. It's important to remember that you are not trained or qualified to dispense medical advice. When working with anyone who has a serious or chronic medical condition, stay within the scope of your personal training practice.

What you can do as a trainer is provide a safe workout that helps your hypertensive client meet their goals. You can also insist that they see their doctor for the go-ahead before working out. While many people with hypertension can and should be active, there may be certain circumstances that prevent your particular client from being able to work out safely.

What to Consider When Personal Training Hypertensive Clients

Exercise is overwhelmingly a good idea for anyone to avoid high blood pressure and for most people who are already hypertensive. For the latter, it's important to create training plans that are safe and that support the client's goal of reducing blood pressure.

Ease into Aerobic Exercise

Even with a doctor's approval to begin working out, it's a good idea to keep the intensity low and to ease into aerobic activity. Aerobic exercise is important for strengthening the heart but getting the heart rate up too high too fast can be problematic with hypertension and may not even be effective. Aim for workouts with 40% to 65% of VO2 max.

Many clients with hypertension are elderly, overweight or obese, and generally sedentary. They may have limited mobility. Start aerobic training with low-impact workouts or non-weight-bearing exercises. Walking, cycling, and swimming are all good activities to elevate the heart rate safely.

Avoid naturally intense exercises and sports. This includes things like heavy weightlifting, sprinting, and many team sports that get the heart rate pounding, like tennis or basketball.

Families can encourage each other by getting active together. Here's how to bring the kids into the program.** **

Extend Warm-Up and Cool Down Times

Warming up to a workout is always important, but for hypertensive clients, it is even more essential. Include a warm-up of more than five minutes to prepare their cardiovascular system for the upcoming workout. This will help prevent a dangerous spike in blood pressure.

The cool down should also be longer than five minutes. Stopping too abruptly can lead to light-headedness, dizziness, and even fainting. A gradual transition is especially important for clients taking medication for high blood pressure.

Introduce Light Strength Training

Aerobic activity is most important for direct heart benefits, but there is also evidence that resistance training can lower blood pressure. Any heavy or intense lifting may be too dangerous for hypertensive clients. This is particularly true for those with very high blood pressure.

Weightlifting can cause quick spikes in blood pressure, so stick with lighter weights and lower-intensity programs when working with hypertensive clients. Gentle, light resistance training is an important part of a long-term plan to manage hypertension.

For a weight training program, stick with lighter weights and more reps. Focus on good form and encourage your clients to breathe through the exercises. People tend to hold their breath, which can cause blood pressure to rise rapidly.

Yoga is a great way to add gentle strength training. It's also a useful tool for managing stress. Here's a blog on how to add yoga to your exercise program.** **

Encourage Daily Activity

For the best results, your clients should be active at least four times per week and ideally every day. This doesn't have to mean doing a full-on workout daily. Assign easy homework for your hypertensive clients, such as taking an evening walk on non-training days. Even small bouts of activity can be helpful, like walking around the office for a few minutes every hour at work.

Work on Weight and Diet Goals

Exercise will help your hypertensive clients, but also encourage a well-rounded plan with additional healthy lifestyle habits. Set reasonable goals for weight loss as a health measure. As your client loses weight, their blood pressure should go down.

Diet is also essential for managing hypertension. The DASH diet (Dietary Approaches to Stop Hypertension) in one option for some people to follow. People with high blood pressure can benefit from cutting back on sodium and reducing alcohol intake.

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