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Resistance training for hypertension

Hadyn Luke posted this on Friday 1st of March 2013 Hadyn Luke 01/03/2013

Tags: Training methods


Resistance training for hypertension

The topic for this blog is hypertension, or high blood pressure, and why it is important for a personal trainer to understand how resistance training can benefit clients with this condition.

What level is considered high blood pressure?

When a fitness professional takes a client’s blood pressure, the optimal readings are: systolic 100-120 and diastolic 60-80. If the readings are any higher, they are categorised as follows:

Pre-hypertensive: 120-140 systolic or 80-85 diastolic

Stage 1 hypertension: 140-160 systolic or 85-90 diastolic

Stage 2 hypertension: 160+ systolic or 90+ diastolic

Find out more from our blog: Guidelines for personal trainers taking blood pressure.

The benefits of cardiovascular training

There’s a lot of debate surrounding the benefits of exercise for clients with hypertension. Traditionally, fitness professionals would recommend that clients with hypertension should follow cardiovascular training, such as cycling, walking, jogging and rowing. However, recent research has shown that resistance training can also be beneficial and personal trainers may want to add it to their client’s fitness programme.

Research referred to in Vol 16/No 1 edition of the American College of Sports Medicine (ACSM) journal (2012) states that regular exercise and physical activity can lower systolic and diastolic blood pressure by approximately 11mm Hg and 8 mmHg respectively.

The ACSM’s Position Stand on Exercise and Hypertension (2004) says that in studies of white males:

“Higher levels of physical activity and greater fitness at baseline are associated with a reduced incidence of Hypertension.”

In particular, research looking at endurance training found that dynamic exercise acutely reduces blood pressure for individuals who have hypertension for a significant part of the day. In other words, if a personal trainer sets a session of aerobic exercise in the morning, this should help keep their client’s blood pressure lower for the remainder of the day. It has also been found that this type of exercise can bring long-term benefits in lowering blood pressure.

The Valsalva manoeuvre

The Valsalva manoeuvre is when an individual has to brace their trunk  musculature to maintain their posture when lifting weights. Due to the isometric nature of the muscle contraction, it can lead to an increase in blood pressure and there’s evidence that resistance training could therefore be detrimental for people with hypertension.

Other dangers of resistance training for those with hypertension

In addition, a balanced programme of resistance training set by a fitness professional would usually include overhead work such as a bench press or a shoulder press. Again, this can increase blood pressure, as it requires the heart to pump blood against gravity up to the working muscles. Equally it means that the blood that was previously in the limbs is dropping back into the blood network, which can increase the overall volume and can therefore increase blood pressure.

Long-term benefits of resistance training

Research shows that resistance training, unlike endurance training, has little effect on blood pressure over a 24-hour period. However, in the long term, resistance training has been proven to reduce blood pressure in both people with high blood pressure and those with ideal blood pressure.

One approach that a personal trainer might therefore find beneficial is to set a programme of endurance training for a client with hypertension to reduce their blood pressure. Once it has reduced to a safer level, they could introduce resistance training so the client can take advantage of the long-term benefits of this type of training for keeping down blood pressure.

Other benefits of resistance training

There are other associated benefits of resistance training for clients with hypertension. These include musculo-skeletal: a client will improve their muscle size, strength, endurance and power. This will help them perform everyday tasks more easily and have a more active lifestyle, which will help manage their blood pressure levels. In addition, they will be able to perform at higher intensities in a gym setting, which means that they can adapt quicker from the training.

Someone with high blood pressure is generally unlikely to be a regular gym goer and a personal trainer will therefore classify them as a beginner and prescribe an endurance routine comprising a high number of repetitions.

Vol 16/No 1 edition of the American College of Sports Medicine (ACSM) journal (2012) refers to a 2011 study on the subject as follows:

“A recent study of hypertensive older adults revealed a higher BP response when subjects performed 15 repetitions with 50% 1-RM than when they performed a single 1-RM lift.”

In other words, there is an argument that if a fitness instructor gives a beginner with hypertension a high rep routine, it could be more detrimental to their health than asking them to carry out a one rep max- in relation to blood pressure.

In all cases, recovery times in between sets should be longer to allow blood pressure to stabilise. However, the underpinning factor when a personal trainer is working with a client with hypertension should always be the individual’s ability, level of training and history.

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