November 17, 2014 | 2 minute read

Q:       I have high blood pressure. What’s the best exercise to help reduce my blood pressure?

A:       Aerobic activity, the kind that increases your heart rate, will have the biggest impact on your blood pressure. The latest recommendations from the American College of Cardiology say that after 12 weeks of moderate to vigorous aerobic exercise (about 40 minutes, three to four times a week), blood pressure will drop. The systolic blood pressure (top number) drops by an average of 2 to 5 mm Hg and the diastolic (bottom number) by an average 1 to 4 mm Hg. Depending on your starting level of fitness, you might begin by walking three days a week for 10 or 15 minutes. Every couple of weeks, add another five minutes to the daily goal. For overall health, try to work up to walking or other aerobic activity five to seven days a week for 30 to 60 minutes. You could reach this with several blocks of 15 to 20 minutes each, if that best fits your lifestyle. Besides walking, other aerobic activities include biking (inside or out), dancing, swimming and active yard work.

As your fitness improves, including some exercise at a vigorous level may bring additional benefits, according to Andrew Freeman, MD, spokesperson for the American College of Cardiology. This level can’t be defined accurately by a specific pace or heart rate, but here’s a rule of thumb you can use: during moderate activity, you can comfortably talk, but not sing; during vigorous activity, you can only say a few words comfortably. Don’t push yourself to a pace beyond that. Before beginning an exercise program of more than modest walking for example, people should get the all-clear from their healthcare provider, and this is especially important if you have high blood pressure. Once your fitness begins to improve, add strength training. Evidence linking it to blood pressure control is inconsistent, but it’s important for overall well being, since without it we gradually lose muscle. If you have high blood pressure, avoid holding your breath or straining with very heavy weights. The combination of regular moderate activity with healthy eating habits and working to reach and maintain a healthy weight can lower your blood pressure and reduce your need for medicine to control it.