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Proceed with caution.

Exercise is the cornerstone therapy for the primary prevention, treatment and control of hypertension (i.e., high blood pressure), according to Exercise and Hypertension, the position stand released last March by the American College of Sports Medicine (ACSM). Hypertension, a common medical disorder associated with increased risk of disease, is the most prevalent cardiovascular condition found in recreational exercisers and athletes. It increases with age and is more common in young men than young women, although the reverse is true in older adults. Resting blood pressure, family history, body mass index and fitness level are known predictors of hypertension. Endurance activities, such as walking, jogging, running or cycling, coupled with resistance training, help prevent the development of hypertension and lower blood pressure. Even a single exercise session provides an immediate reduction in blood pressure, which can last up to 22 hours.

However, ACSM cautions that hypertensive individuals should be evaluated, treated and monitored closely. People with controlled hypertension and no cardiovascular or kidney disease may participate in an exercise program, but there is limited ability to forecast exercise blood pressure and cardiovascular complications due to possible underlying clinical conditions.

According to ACSM, special considerations for exercise with hypertension include the following.

* The type, frequency and duration of activity are important. People with hypertension should exercise daily for 30 minutes or more at a moderate level to gain health benefits.

* People using medications, such as beta-blockers, should be cautious of developing heat illness when exercising. These medications and diuretics impair the ability to regulate body temperature.

* Adults with hypertension should extend the cool-down period of the workout. Antihypertensives, such as alpha blockers, calcium channel blockers and vasodilators may cause blood pressure to lower too much if exercise ends abruptly.

* Overweight and obese adults with hypertension should combine regular exercise and weight loss to effectively lower resting blood pressure.

* Explaining the ability of a single exercise session to lower blood pressure may be the best way to motivate people to exercise. Physicians should promote exercise's role in controlling blood pressure.

* It is necessary for those with severe or uncontrolled blood pressure to get an evaluation and clearance from a physician prior to beginning an exercise program. Patients at higher risk (e.g., those with coronary artery disease or chronic heart failure) should lessen the intensity of their training programs.

For a complete copy of the position stand, visit Medicine & Science in Sports & Exercise, ACSM's official journal, is available from Lippincott, Williams & Wilkins at (800) 638-6423.

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Title Annotation:Health & Medicine
Publication:American Fitness
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 2004
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