3 Exercise Considerations for Clients’ with High Blood Pressure

Physical activity and exercise is a great way to help manage high blood pressure with associated benefits such as controlling weight. There is a wealth of research now to support the link between exercise and reducing blood pressure.  Therefore, as fitness instructors you should be encouraging people to exercise for their health, but you need to ensure that you are suitably qualified to deal with the diverse range of potential client’s. In order to develop your understanding of cardiovascular health and associated medical conditions, it is recommended to complete the L3 Diploma in Exercise (GP) Referral course. Within this course we cover various exercise considerations and implications associated with hypertension (high blood pressure) and fitness instructors benefit from this new perspective which allows them to develop their confidence when working with client’s who state they have high blood pressure.

Today we are highlighting 3 exercise considerations which should be addressed when working with client’s. Let’s have a look….

1. Ensure a Medical Professional has Cleared the Client to Exercise

Around 16 million people in the UK have high blood pressure at present (Bloodpressureuk.org); therefore, the chances of you meeting a client with the condition is reasonably high. High blood pressure is effectively controlled by medication these days which allows people to continue their everyday lives as they did before. A reasonable number of client’s probably wouldn’t think to inform you that they have high blood pressure and may be taking medication. As a result, it is ESSENTIAL that you ask all clients’ to complete a PAR-Q (physical activity readiness questionnaire). Here they should identify if they have any medical conditions that you need to be aware of. If they do highlight that they have blood pressure issues then you must ensure that they have received clearance from a medical professional. Although this can be a barrier to exercise, you need to identify that the client’s condition is stable in order for you to exercise with them safely and effectively. Plus you have to protect yourself as a fitness professional. You want to make sure that you are following the correct protocol so everyone involved is protected.

2. Perform a Gradual Warm Up

Once you are sure that your client is safe to exercise then you need to focus on your session content. During the L3 Exercise Referral course we discuss in detail the need for a gradual, extended warm up. The warm up should last around 10-15minutes and gradually increase in intensity. Starting with lower body movements and progressing to adding in the arms is recommended. Movements which combine the lower and upper body together significantly increase heart rate so this tends to be integrated once the pulse has been raised slightly i.e. From 3 minutes onwards as a guide. The aim with the warm up is to gently increase the demand on the cardiovascular system as opposed to placing a sudden demand on the heart. Always think to keep the feet moving as blood pressure medications aim to reduce the demand on the heart; therefore, heart rate can quickly drop back down. So remember to plan time in your session for an extended warm up (and cool down).

3. Encourage Good Breathing Technique

Combining aerobic exercise with resistance training is the most effective way to improve health and wellbeing of the whole population. The main consideration when working with hypertensive clients’ is to be aware of correct breathing patterns. When lifting weights, people often perform poor breathing technique or the Valsalva manoeuvre. This causes blood pressure to increase and is therefore something we want to avoid. A good instructor would teach and reinforce breathing throughout every session.

A myth regarding weight training with people that have high blood pressure is that they cannot lift weights above their head. This is not true, they can; however, not for extended periods of time and not with an excessive weight.

In summary, once you have clearance you can train a client with high blood pressure the same as the majority of the population but be mindful of these key considerations. Think about intensity, durations and technique.  Also, be considerate of exercise history, ability and confidence.

Hope you found this information helpful and you can put it into practice if you are not already.

If you wish to learn more detail about hypertension alongside other cardiovascular conditions then the progression pathway would be to complete the L3 Exercise (GP) Referral Course.


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