Hypertension is best managed by combining life-style modifications (exercise and dietary modifications) and medications. For certain blood pressure readings, your healthcare professional will start you on only dietary modifications, exercise and stress management. There are currently many effective medications but without the appropriate life-style changes, your doses and number of medications will be increased over a period to control your blood pressure and reduce the incidence of complications. Increasing the dose and types of drugs also come with an increase of drug side-effects and drug-drug interactions.

As we approach World Hypertension Day (17^th May), I encourage all of you to measure your blood pressure and get as many people as possible to do the same. This month make blood pressure monitoring your goal.

Suggestions made here only act as guidelines, only your healthcare professional together with a qualified fitness therapist can recommend the appropriate exercises. It is highly recommended that you get a clearance from your doctor before starting any exercise programme.

Life-style modifications to help manage/prevent hypertension:

• Exercise
• No smoking
• Limited (or no) alcohol consumption
• DASH (dietary approaches to stop hypertension) diet : low sodium(salt), increased potassium from fruit and vegetables, low or no saturated fats and increased fibre
• Fat (weight) loss
• Stress management/adequate sleep

It is important to know that when it comes to the benefit of exercise in lowering blood pressure, you cannot rely on “past glory”. The exercise you do now is what matters. The benefit of lowering your blood pressure will last for a maximum of 72 hours. That is why we prescribe regular exercises.

Exercise plays a vital role in the management of hypertension. There are four or five broad categories of exercise and all of these are vital in the wellbeing of an individual and in the lowering of blood pressure.

• Aerobics – Moderate intensity aerobic exercise improves cardiac function and lowers blood pressure. Also makes blood vessels more flexible.
• Strength training – Increases endurance, reduces heart’s demands during daily activities, helps to reduce blood pressure at rest, makes client stronger and reduces stress. It also helps us to lose fat.
• Stretching – Plays a complementary role by increasing tendon flexibility, improving joint ROM (range of movement) and function and hence incidence of injury that can cause pain and increase blood pressure. It also enhances muscular performance.
• Balance Training

Helps to strengthen our core, reduce risk of falls and injury

• Corrective Exercise

A terrific way to prepare your body so that you are able to do more exercises and make more gains

Warm Up and Cool Down: Warming up will take 5-10 minutes each session and should be done religiously. Warming up is the process of preparing the body for more vigorous exercise. It should be gradual and one only needs to break into a light sweat. Cool down should also be long to ensure heart rate etc returns to close to normal levels. Warm up and cool down are extremely important in every exercise regime and more so in one with hypertension or heart disease. NEVER start or end any exercise session without these two.

Certain high blood pressure readings may require rest for a while before exercising. You may need to avoid certain exercises such as abdominal exercises since they cause an increase in intra-abdominal pressure (valsava) and probably blood pressure. In certain cases you may need to avoid strength training or weight training briefly and concentrate on aerobic or cardiovascular exercise such as walking, cycling, treadmill etc., flexibility exercises, balance exercises and corrective exercises.

Many people are wary of weight training or strength training, especially adults with high blood pressure but as stated earlier, this form of exercise also plays a vital role in managing high blood pressure. It is important to note the following:

• Avoid exercises that require lifting weights above the head; supine exercises preferred
• Limit the number of sets and repetitions for upper body exercises e.g. arms, chest, shoulders etc
• Increase or maximize the number of repetitions and sets for lower body exercises such as squats for thighs etc since these tend to help reduce blood pressure through a complex mechanism including peripheral pooling of blood just after exercising

It is important to note that when exercising to control blood pressure (like in all other cases) one needs to start gradually and increase the duration and type of exercises over a period. The rule of thumb is to listen to your body at all times – NO PAIN NO GAIN IS INSANE!!!!

AS ALWAYS LAUGH OFTEN, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)

Dr. Kojo Cobba Essel

Health Essentials/St Andrews Clinic

(www.healthessentialsgh.com)

*Dr. Kojo Cobba Essel is a Medical Doctor, holds an MBA and is ISSA certified in Exercise Therapy, Fitness Nutrition & Corrective Exercise.

Thought for the week – “MAY MEASUREMENT MONTH (MMM18) – this May make it a point to MEASURE YOUR BLOOD PRESSURE. Encourage as many people as possible to measure their blood pressure too. This is a life-saving act.”