Exercise with a Plan If You Have High Blood Pressure, Diabetes

Running is an example of a dynamic exercise that is beneficial for people with high blood pressure or diabetes.


The exercise and fitness specialists at UW Health Sports Medicine's Fitness Center have a saying that in many ways defines their work and mission.


"Exercise is medicine," says Fitness Center exercise physiologist Dan Wanta. And when it comes to two common disorders - high blood pressure and elevated blood sugars - Dr. Heather Johnson agrees.


Johnson, a UW Health cardiologist comments, "Regular exercise is just as important as your medications. Exercise and, if needed, weight loss can decrease the amount of medications prescribed for your blood pressure and blood sugar."


But Wanta and fellow Fitness Center exercise physiologist Jude Sullivan offer their "prescription" with a proviso: people diagnosed with hypertension (high blood pressure) or diabetes (the inability to produce and/or use insulin properly to control blood sugar levels) should talk with their doctor before starting a new exercise program to learn how to safely monitor blood pressure and blood sugar.


Exercise and High Blood Pressure


High blood pressure afflicts nearly 70 million people in the United States, according to the Centers for Disease Control, and greatly increases the risk of heart attacks and strokes. The behavioral causes are many, and a sedentary lifestyle is right up at the top of the list, along with a poor diet and smoking.


Learn about risk factors and management strategies for high blood pressure


But behaviors can be controlled, which means embracing physical activity can reverse the negative effects of a sedentary existence.


"Exercise on most days of your life," Wanta says, a recommendation that applies no matter your blood pressure or blood sugar levels. "Get 150 minutes of moderate, or 75 minutes of vigorous, activity per week."


Dr. Johnson adds, "If your goal is weight loss - gradually increase your exercise to 300 minutes of moderate-intesnity exercise per week." And it doesn't have to be completed all at once, she adds. "If necessary, divide your exercise into smaller amounts of time - 10-15 minutes per session - to fit it into your busy schedule and to allow your body to adjust to a new exercise program."


That regular, repeated activity makes your heart stronger and relieves the pressure the heart places on the arteries. But people with high blood pressure benefit from a sharper exercise focus.


"Dynamic exercises, which involve large muscle masses in a rhythmic and continuous manner for a modest to long duration, have been shown to have the strongest effect on chronic blood pressure," Wanta says.


Walking and jogging are good examples of dynamic exercises. But before you hop on that treadmill or browse the internet for deals on running shoes, Sullivan says it's prudent to find out how your blood pressure reacts to exercise. While blood pressure is expected to rise during even low levels of physical activity, dramatic jumps in blood pressure during activity can be a warning sign, and possibly dangerous.


That's the reason the Fitness Center performs a simple, effective test prior to making exercise recommendations to new members. In addition to providing an oral medical history, new members submit to an eight- to 10-minute treadmill walking test during which their blood pressure and heart rate are monitored.


"Let's say during a walking test a person is rating the exercise to be easy," Sullivan explains, "but we notice that their systolic blood pressure goes up to 200 once they start walking faster. We expect systolic blood pressure (the upper number) to go up with progressively more challenging workloads, but this increase in blood pressure appears to be disproportionate to how they're rating the effort. This would attract our attention and encourages us to evaluate this individual’s responses further."


The treadmill test, then, provides information specific to that person's capacity for exercise, and informs Sullivan's recommendation.


"We're not going to have them move past that zone right away," he says. "We might have them exercise at that level for a few weeks and collect more information, and communicate it back to the physician so we can collectively make a smart decision."


Dr. Johnson comments from the physician's perspective, "We enjoy working together with our exercise physiologists to help each person achieve their exercise goals and live a healthier life."


Many factors contribute to how exercise can impact your blood pressure levels:

  • Type of exercise you choose: Exercises having a greater strength component, such as cycling, can raise levels higher than normal.
  • Intensity: Probably the  most influential element.
  • Breathing: Breath holding can be a more common occurrence than you realize, especially when strength training, and has a tendency to spike blood pressure higher than normal.

All should be considered by you and your health care team when constructing a smart plan.


Exercise and Blood Sugars


Not only does exercise acutely reduce the body's blood sugar level but, when performed regularly, is an integral method for managing blood sugars over the long term. Regular physical activity is tremendously beneficial for the nation's 29 million diabetics, be they Type 1 (the body produces no insulin) or Type 2 (the body doesn't use insulin properly). The blood sugar spikes that characterize diabetes can be in part mitigated with exercise, as regular, physical activity encourages the body to use insulin more efficiently.


Learn about Diabetes Management


"Exercise has been shown to significantly increase insulin sensitivity - helping your muscles use the insulin more beneficially," Wanta says.


But the blood sugar response to exercise varies from person to person. Wanta and Sullivan encourage diabetics adopting a new fitness regimen to work with their health care teams to monitor how their bodies react.


"How they respond is different for each person," Sullivan says. "We expect their blood sugar will go down after they exercise. For some, it's not a big deal, because they start high. But other people could bottom out, and that's a huge deal."


Bottoming out can result in stupor, disorientation, weakness, blurred vision and shakiness - states that can lead to injury when engaged in physical activity. That's where the counsel of specialists like Wanta and Sullivan proves invaluable.


"We want to err on the side of caution with how long and how hard you're going to exercise," Sullivan says. "And we'll help you evaluate your routine in a systematic way."


"And it's reassuring if you're in an environment where people know you," Wanta adds. "We can say, 'Let's take a break and maybe have a drink of juice or a snack.' We can recognize symptoms in a safe environment and respond accordingly."


Many factors contribute to how exercise can relate to your blood sugar levels:

  • When you exercise.
  • Type of exercise you choose.
  • Duration and intensity of exercise
  • Blood sugar levels before and after exercise

All should be considered by you and your health care team when constructing a smart plan.



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Date Published: 06/10/2016

News tag(s):  sports medicine

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