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High blood pressure makes exercising – and exercising cautiously – more important. Take control of your health, but be smart.Getty Images/iStockphoto

Regular physical activity is unequivocally recommended for people with high blood pressure. As Dr. Paul Oh, medical director and GoodLife chair of the University Health Network Cardiovascular Prevention and Rehabilitation Program, reminded me in an interview, the combination of aerobics and weight training is as effective for lowering blood pressure as many medications.

The caveat is that exercise is recommended, but within certain guidelines. High blood pressure makes exercising – and exercising cautiously – more important. Take control of your health, but be smart.

According to Oh, when it comes to exercising with high blood pressure, "be cautious … but don't be afraid." Adopt the mindset that daily motion is "non-negotiable" but also communicate with your doctor; have regular checkups and learn – and follow – appropriate guidelines.

Here are five guidelines for working out with high blood pressure:

1. Be smart at the gym

Breathe: Holding your breath increases your blood pressure.

Tailor your workout: Perform exercises one arm or leg at a time and be cautious of exercises that require putting your arms above your head, those that place your head below your heart and isometric exercises.

Also, tweak isometric exercises to make them more dynamic. For example, instead of static wall squats to prep for sports such as skiing, consider a 1-1/4 squat: Lower for four counts, hold briefly, do a quarter rep by coming up partway and then immediately squat back down. Stand up to finish.

Prioritize warm-up and cool-down: Warming up gradually increases heart rate, increases circulation to muscles, tendons and ligaments and mentally prepares you. With high blood pressure, your circulatory system is not as resilient and pliable, thus this graded increase in activity is key. The cool-down redistributes blood back to the heart, which, as Oh stressed, is vital for individuals with high blood pressure; blood-pressure medications can increase blood flow to the extremities.

2. Get in control

"Get in control" is Oh's phrase to highlight the importance of actively aiming to achieve a healthy blood pressure. According to Oh, a large component of "getting in control" is being mindful of medications. Know what you are taking, be fastidious about taking them and learn how each affects your body.

Certain medications change heart-rate response and the response may vary depending on time of day. For example, beta blockers blunt heart rates, making it difficult to elicit a heartbeat within the typical recommended zone on a cardio machine. Know that so you don't feel your workout is useless and give up. Cardio is always useful.

3. Live by the "some motion is better than no motion" rule

Take every opportunity to weave activity into your life. Aim to sit less and move more; you don't have to train for hours a day to reap benefits.

4. Consider yoga, tai chi and other forms of stress management

Emotional and psychosocial stress influence physiological and psychological health; find a form of stress management that works for you.

Tailor your "stress intervention" to your needs, lifestyle, life realities and personality.

5. Create diverse yet complimentary goals and measures of success

According to Hypertension Canada, more than 80 per cent of Canadians with hypertension have additional cardiovascular risk factors, including unhealthy diet, high dietary sodium intake, tobacco use, physical inactivity, abdominal obesity, dyslipidemia, dysglycemia and high waist circumference (above 102 centimetres in men and 88 centimetres in women).

Improving health is multifactorial. Don't just monitor your blood pressure. Use multiple barometers of success. Set nutrition and fitness goals, aim to quit smoking and track your energy, sleep and waist circumference. The more goals and metrics of success you establish, the more reasons you will have to stay on your health horse.

Kathleen Trotter is a personal trainer, Pilates equipment specialist and author of Finding Your Fit. Follow her on Facebook or Twitter @KTrotterFitness.

The Great Trail, formerly known as the Trans Canada Trail, is a series of hiking, skiing and water trails that together span the country. At the end of August the Great Trial will be considered officially complete, with all of its segments linking up.

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