Exercise can be beneficial for many patients with hypertension if done carefully.


Medical clearance for exercise is indicated for:

(1) severe hypertension

(2) history of coronary artery disease or other significant comorbid condition

(3) secondary hypertension

(4) deconditioned individual

(5) recent surgery or injury

(6) solitary kidney or other condition in which injury may have serious implications


General recommendations for an exercise program:

(1) moderate intensity

(2) performed on most or all days of the week

(3) cumulative duration of at least 30 minutes per day

(4) consists of endurance physical activity and resistance exercises


Activities to avoid (due to the risk for a sudden rise in blood pressure):

(1) weight lifting and body building

(2) isometric or intense resistive exercise


The evaluation should include a review of:

(1) body weight, with determination of target body weight

(2) dietary advice, especially restriction on salt and fat intake

(3) concurrent medications that may impact

(3a) tolerance of temperature extremes (high or low)

(3b) blood glucose levels

(3c) dehydration

(3d) electrolyte imbalances

(3e) cool down phase

(4) history of conditions that might impact safety

(4a) hypotensive or syncopal episodes

(4b) hypoglycemia

(4c) asthma

(4d) seizures

(4e) cardiac arrhythmia

(5) need for acclimatization

(6) need for moderation in alcohol and caffeine use

(7) need to discontinue the use of nicotine

(8) need to avoid use of illicit drugs, especially stimulants


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