Why does blood pressure increase when walking - norm and deviations, techniques for hypertensive patients

The normal blood pressure range is from 100/60 to 140/90. But even in healthy people, after physical activity, such as walking and running, this figure may become slightly higher. This happens because blood circulation in the body increases sharply. You should only panic if the increased pressure, after the cessation of the factor that caused it, does not return to normal levels after some time. The permissible time for changed pressure due to external factors is 5 – 8 hours. If the indicators do not become normal for longer, then the risk of diseases associated with surges in blood pressure increases many times over.

Normal blood pressure at rest and when walking

Pressure at rest corresponds to the age norm: ideal –120/80 mm Hg. up to 50 years, 140/90 - after 50. Therapists, cardiologists, neurologists say that the norm when walking can be considered an increase in the systolic indicator within 50 units, and diastolic - 20. Anything that goes beyond the boundaries of these values ​​indicates stress , disease or minimal adaptive potential of the patient.

Squat, large people are practically unfamiliar with blood pressure fluctuations during movement, but in men the upper level is always higher than in women. If half an hour after the end of the physical activity the pulse and blood pressure return to normal without outside help, there is no reason to worry. High numbers that persist for more than an hour suggest contacting a doctor.

“Normal” blood pressure reactions to CST

With increasing physical activity, SBP increases linearly, mainly due to an increase in cardiac output to satisfy the demand from working muscles. Sympathetically mediated vasoconstriction reduces splanchnic, hepatic and renal blood flow (this increases vascular resistance), the local vasodilatory effect suppresses vasoconstriction (“functional sympatholysis”), allows the redistribution of cardiac output to working skeletal muscles and reduces overall peripheral vascular resistance. These opposite reactions contribute to the maintenance or slight decrease in DBP during CST. A detailed discussion of the regulatory mechanisms of these reactions is beyond the scope of our review; they are widely discussed elsewhere (20). The American College of Sports Medicine (ACSM) and the American Heart Association (AHA) define a “normal” response as an increase in SBP of approximately 8 to 12 mmHg. Art. (2) or 10 mm Hg. Art. (3) per metabolic equivalent (MET – 3.5 ml/kg/min). The source of these values ​​is a 1973 textbook study where healthy men (with unknown sample size and age) showed mean and peak SBP increases of 7.5 and 12 mmHg. st./MET, respectively. An abnormally elevated (“hypertensive”) response to exercise was defined as exceeding these values ​​(12 mmHg/MET) (5). Thus, widespread and long-standing recommendations defining a “normal” response to CST are limited by data from a single study of men with a poorly characterized phenotype. Below we will present information about the significant impact of the blood pressure response to CST depending on gender, level of training, concomitant diseases and associated medications.

Influence of age and gender

In a study of 213 healthy men (4), changes in SBP in response to increasing exercise intensity increased with each decade of life. The largest increase in SBP per MET was observed in the oldest group (50–59 years; 8.3 ± 2.3 mmHg/MET), compared with an average increase of 5.7 ± 2.3 mmHg. Art./MET in the youngest group (20 – 29 years old). With age, the slope of the response graph increased (p <0.001) (Fig. 1a).

Data on the effect of gender on BP response during CST are limited. A group of healthy women aged 20–42 years responded with an average increase in SBP of 5.0±1.1 mmHg. st./MET (21). The slope of the graph should be less than that of men of the same age (Fig. 1b, p <0.001). It is noteworthy that the average increase in the groups of men and women was much lower than the “normal” response range of 8 – 12 mm Hg. st./MET. In contrast, current studies of the effects of age and sex suggest that in older women, the hypertensive response to exercise occurs due to a limited ability to reduce systemic vascular resistance (22). Unfortunately, there are no data on the BP response to exercise in older adults (>65 years), which limits our clinical interpretation of the BP response to CST.

Impact of health status and medications

The level of training during CST behaves as an independent factor influencing blood pressure. According to Fick's rule, maximum oxygen consumption (VO2max) depends on cardiac output and the arteriovenous oxygen difference. A higher VO2max value corresponds to a higher cardiac output, which means a greater increase in SBP. Therefore, when interpreting the maximum SBP obtained during CST, it is necessary to take into account the level of training (VO2max). The rate of change in SBP can also change with the level of training. In a study of young men, 16 weeks of endurance training increased VO2max and peak SBP (Fig. 2a) during CST (23). When we plotted the increase in SBP during CST versus VO2max, the slope of the curve after training was steeper (Fig. 2b; p=0.019). In women, differences in SBP during CST are also observed depending on training. With increasing training, SBP with CST is lower than that of sedentary peers. Young, exercised women achieve higher SBP at the end of the test compared to their sedentary counterparts (24).

Rice. 1. Response of systolic blood pressure (SBP) to a progressive exercise test in healthy people.

Values ​​are presented as changes (Δ) in SBP compared to baseline values ​​with increasing exercise intensity, expressed in metabolic equivalents (METs):

• a) data from healthy men, divided by decades of life;
• b) data from healthy men (20 – 39 years old) and women (20 – 42 years old).

The figure is based on previously published values ​​(4, 21). Regression equations are presented for each gender.

* p < 0.001 for between-group differences in the slope of the SBP response curve.

Rice. 2. Systolic blood pressure (SBP) response before and after 16 weeks of endurance training in healthy men:

• a) the maximum SBP was obtained in a test with a gradual increase in load;
• b) the increase in SBP during the test is shown as a percentage of maximum oxygen uptake (VO2max).

The figure is based on previously published values ​​(23). Before/after regression equations are shown.

* p < 0.05 for differences in the slope of the SBP response curve.

Comorbidities, especially those affecting BP and its regulation, or other indicators of cardiovascular disease also influence BP response to exercise. In people with normal and untreated hypertension (without known baroreflex sensitivity impairments), there is a similar increase in SBP and mean BP with increasing exercise intensity, but the higher baseline BP in people with hypertension results in greater values ​​at maximal effort (25, 26). Conversely, people with hypertension and impaired arterial baroreflex sensitivity experience a greater absolute increase in BP during bicycle ergometry (27). Individuals with changes in autonomic nervous system function also differ in their BP response to exercise, as cervical spinal cord injuries (eg, tetraplegia) are typically associated with altered cardiovascular activity due to absent or reduced sympathetic tone below injury levels (28). Some studies have shown a decrease in SBP with exercise in people with tetraplegia, compared with healthy controls and people with paraplegia (partial or complete preserved sympathetic tone below the level of injury) (29, 30). Similarly, people with diabetes and autonomic neuropathy experienced less of a rise in SBP from baseline and reached lower peak values ​​(37 ± 6 mmHg and 158 ± 7 mmHg, respectively) compared with people without autonomic neuropathy ( 55±8 mmHg and 176 mmHg) (31). In addition, in patients with coronary artery disease, dyslipidemia, and diabetes, aerobic exercise may increase DBP (32, 33). All of these responses are distinct from the pathological conditions associated with exercise hypotension (10 mmHg decrease in SBP with increased exercise) (2, 3), including coronary heart disease and left ventricular dysfunction (34 – 36). Medications prescribed in this clinical population also lower exercise BP: nitrates, calcium channel blockers, diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers (37). Regarding β-blockers, by recording SBP directly from the brachial artery during bicycle ergometry, Floras et al (38) showed a significant attenuation of the SBP response by chronic blockade of cardioselective β1-adrenergic receptors; but nonselective blockade of β1 and β2 adrenergic receptors did not alter this BP response.

Impact of the CST protocol

The type of CST also influences the blood pressure response. In healthy men, four progressive treadmill protocols resulted in similar maximum SBP (39), whereas in women the slope of the SBP response curve and maximum SBP observed in the Bruce and Balke treadmill protocols were significantly different (21). Treadmill and cycle ergometer exercises, with stepwise and continuous increases in exercise, produced similar maximum SBP in men (40). However, bicycle ergometry results in greater maximum SBP in the clinic (41) and in trained individuals (42), possibly due to the addition of isometric work (hand grip) or increased quadriceps activation (and thus sympathetic afferent activity). Therefore, when interpreting the BP response to CST, the type of exercise must be taken into account.

Blood pressure surges that require medical advice

Blood pressure has the ability to change throughout the day. This is normal if the systolic and diastolic values ​​are stable. Violation of the natural balancing of blood vessels leads to their jumps: from minimum to maximum and vice versa. This situation is dangerous, since the arteries may not withstand sudden changes, burst, and provoke the development of a heart attack or stroke.

Older patients are at risk for hypertension. For hypotensive patients, such changes threaten the development of hypoxia due to insufficient oxygen supply to the tissues. It is jumps in blood pressure that are a reason to consult a specialist, since without the exact cause of the pathology, its adequate treatment is impossible.

How to minimize blood pressure surges when moving

Problems with blood pressure due to physical activity are often harbingers of hypertension, so you need to consult a specialist as soon as possible, undergo the necessary diagnostics and prescribed treatment. The doctor will most likely recommend the use of various synthetic drugs in a certain dosage.

But if it is determined that this phenomenon is non-pathological in nature, or in addition to drug therapy, you can use various folk remedies that will help cope with unpleasant sensations.

Foods that can lower blood pressure include flax seeds, red pine cones, and more.

To prevent blood pressure from jumping up after walking, it is often enough to follow the following recommendations:

• It is necessary to walk in the fresh air every day;
• Walking speed should not be too fast. The appearance of shortness of breath will just lead to an increase in blood pressure. Therefore, it is better to walk at a comfortable pace;
• You can gradually increase the distance you walk each day;
• When walking, it is not the speed that is important, but the distance covered. To monitor this process, you can use a pedometer or a smartphone application.

Leading a healthy lifestyle has a beneficial effect not only on blood pressure, but also on the body as a whole. If the condition does not improve as a result of therapy and daily walks, then most likely the therapy was chosen incorrectly.

It is also important to remember that if pressure rises only after physical activity, and the rest of the time remains within the normal range, then the reason for this may be increased emotionality or error in measurements.

The benefits of walking for hypertension

Walking is an option for a healthy lifestyle and is a natural physical exercise. Blood pressure while walking is a biomarker of fitness or compensatory potential of the cardiovascular system. An increase in the upper or lower indicator during movement indicates insufficient dosed physical activity on the body.

Walking is healthier than spending time passively. They improve skin tone, reduce the risk of sudden death in the elderly, burn calories, fight insomnia, strengthen bones, stabilize hormonal balance, psycho-emotional mood, and prevent glaucoma and diabetes.

Walking also maintains optimal condition of the heart and blood vessels:

• the risk of acute conditions associated with surges in blood pressure is reduced;
• migraine headaches disappear;
• vascular tone, immunity, and the patient’s well-being increase;
• stress resistance increases;
• respiratory function is normalized due to intensive oxygen supply to tissues.

Walking is an excellent type of anaerobic training for a healthy person and a patient suffering from hypo- or hypertension. Doctors emphasize the advisability of different types of walking.

Dosed

Advertising:

The optimal way to improve health for patients with hypertension, hypotension, and other diseases of the cardiovascular system is dosed walking. It is especially indicated for rehabilitation after serious illnesses, surgical interventions, heart attacks, and strokes.

As a rule, such physical impact is short-lived and stimulates the functional potential of any internal organ. A sharp increase in effort is excluded, a gradual increase in distance, the time of movement is coordinated by the doctor.

Scandinavian

This type of walking involves the use of special sticks. Today it is the most effective, safe type of vascular training for patients of all ages, which guarantees:

• increasing myocardial contractility with a simultaneous decrease in arterial load;
• getting rid of extra pounds;
• stable psycho-emotional state, good mood;
• lowering blood cholesterol levels;
• stable decrease in elevated blood pressure by 9 units.

The first lessons take half an hour. Every 5 days their duration is increased by 10 minutes, up to an hour. This is the optimal training time.

Sports

Advertising:

Here you need to monitor your blood pressure and monitor your posture. This “work” is not suitable for everyone; trained patients can move at a speed of 7 km/h, athletes – 15 km/h. The entire training process is subject to coaching control. Not only the speed of movement is important, but the length of the step, rhythm, and change of pace.

Ski

Ski trips are loved by many. This is a very useful type of natural vascular training that prevents the development of hypertension in patients of any age.

But skis require some restrictions:

• the temperature should not exceed minus 10 degrees Celsius;
• snowfall and wind are a taboo for “travel” on skis;
• short distances are ideal, taking an hour of time with breaks (you can walk twice a day).

Compliance with all the rules of skiing brings joy and health, guaranteeing active longevity.

Healthy types of walking

There are several types of walking. Depending on the season and personal preferences, you can choose the best option.

Dosed walking

This variety is considered a natural form of physical therapy. For walking, you should choose smooth roads without slopes and start by walking 1 km per day, gradually increasing the distance to 3 km. This can be done once every 3 – 5 days in increments of 500 – 1000 m. If these loads are well tolerated, you can gradually increase the pace of walking and reduce the rest time. The speed can vary from very slow (70 steps per minute) to very fast (140 steps in 60 seconds). If after the next increase in pace there is a deterioration in health, then you should return to the previous speed. You cannot overload the body, otherwise even walking will do harm instead of good.

Race walking

Race walking is somewhat similar to running, but puts less stress on the joints. There are several features for this type of load:

• The speed of race walking is 130 – 200 steps per minute (this is a very fast pace, the distance covered is approximately 6.5 km per hour);
• During the process, one of the feet remains firmly on the ground at all times;
• The pitch is 90 – 120 cm;
• The supporting leg cannot be bent at the knee;
• The hands move quickly.

Race walking puts less stress on your joints

Nordic walking

This type of walking is carried out with the help of special sticks and uses all the muscles of the body, which has a beneficial effect on their condition and well-being in general.

Contraindications

Despite the obvious benefits of walking for the heart and blood vessels, abuse of such physical activity can cause harm. Complete refusal from walking training is applicable only if negative symptoms appear. The choice of the type of physical activity is decided by the doctor. Contraindications to walking are well known:

• frequent pressure surges of unknown origin;
• ACVA – stroke;
• thrombosis of blood vessels of the lower extremities.

This helps the patient and physician reach the necessary consensus when choosing a payload.

Reasons for increased blood pressure while moving

Advertising:

The answer to the question of why movement causes an increase in blood pressure lies in the compensation mechanism. Even moderate walking constricts blood vessels, impairing blood flow to the organs. As a response, a rapid heartbeat occurs, the heart muscle sends more blood to the capillaries to compensate for the increasing hypoxia.

If the walk takes more than 45 minutes, all indicators return to normal.

Only in patients with minimal adaptive capabilities does blood pressure remain high during movement. A number of provoking factors contribute to this: time of day, gender, age, body constitution, weather sensitivity, medication, psychosomatics, fitness. A significant jump in blood pressure is recorded with age-related changes, a sedentary lifestyle, and concomitant diseases.

Low Pressure Triggers While Walking

Low blood pressure after walking or dosed physical activity is not uncommon. This is explained simply: the body experiences overload and tries to save energy. This condition cannot be ignored, since its triggers can be a number of diseases:

• vegetative-vascular dystonia: the lumen of the vessels does not have time to adapt to the situation, hypotension occurs;
• heat stroke leads to a decrease in blood pressure to critical levels: less than 90/60;
• mitral valve prolapse;
• paradoxical hypertension at the onset of pathology;
• physical activity after a long absence from sports;
• weakness of the sinus node;
• angina pectoris with outcome in AMI.

All these conditions require medical intervention, sometimes emergency measures.

How to measure pressure correctly?

There are certain rules for measuring pressure. “Blood pressure is measured either at home or at a doctor’s appointment by placing a blood pressure cuff on your right or left arm. When taking the first measurement, it is worth taking it on both arms,” says the cardiologist.

It is worth taking an average measurement. “To do this, we measure the pressure on both hands and the third - a control one. Then we take the average. For example, a person has 125 on his right hand, and 120 on his left, the top bar, but with the third measurement it turns out to be 123-125, then we take the larger number as the average. This will allow you to find out what the maximum pressure is for a person and focus on it,” advises the cardiologist.

“Different pressure readings on the arms indicate differences in blood flow. And in the future it will be necessary to measure the pressure on the arm where the indicator is higher,” says Azizkhon Askarov.

The best way to measure blood pressure is on the shoulder. Today there are devices that measure on the wrist, but they are not considered as informative as measurements in the shoulder area, emphasizes Azizkhon Askarov. The cuff must be applied in a certain way: it is located at the level of the elbow at a distance of two fingers, or 3-4 cm. At this distance, the lower edge of the cuff must be tightly applied so that one finger fits under it, says the cardiologist. The shoulder should be at the level of the heart in order to obtain more accurate measurement results.

There are other conditions for qualitative measurement. So, measurements should be taken after 15-20, or preferably 30 minutes of rest, for example, if a person came to the clinic or returned home from work. “Also, a person should not drink caffeine-containing drinks (tea, coffee) 30-40 minutes before measuring. It is advisable not to smoke for 40 minutes before measurement. In addition, you should wear loose clothing,” advises cardiologist Askarov.

In addition, the person should not experience discomfort before the measurement. For example, if he has a full bladder or a sore throat, you first need to eliminate the source of discomfort, and only then measure the pressure. The environment should be calm and relaxed. It is advisable for a person to sit on a chair with a back or on an armchair, leaning comfortably.

“It is better, of course, to measure with an automatic or semi-automatic device. Not all patients know how to use a mechanical tonometer,” says Azizkhon Askarov.

Before or after a meal is not so important. But at the same time, if you want to measure the pressure afterwards, you should wait half an hour. In general, as the specialist notes, it is better to measure blood pressure in the morning within 5 minutes after waking up and in the evening - 20-30 minutes before bedtime.

Blood pressure is under control. Why is it important to prevent hypertension Read more

Diseases that provoke a pathological condition

Advertising:

Not only hypotension, but also pressure surges during movement can be caused by somatic pathology. Then consultation with a specialist is necessary to accurately diagnose the disease that caused the problem, since often such pathology indicates a danger to life and requires emergency care. The causes of hypertension are:

• thrombosis of deep or superficial vessels of the lower extremities;
• renal pathology with outcome in chronic renal failure (chronic renal failure);
• cerebrovascular accident;
• hormonal imbalance;
• stable hypertension of unknown origin;
• diseases of the musculoskeletal system.

The presence of these diseases is a reason for a thorough analysis of the patient’s compensatory capabilities when choosing physical activity.

Negative symptoms

Advertising:

Usually, any walking, subject to the doctor's recommendations, does not cause negative symptoms in patients. However, there is one category of people who react even to a leisurely walk with hypertension, shortness of breath, cyanosis of the skin and mucous membranes, tachycardia, and an increase in the volume of blood circulating through the vessels.

A change in posture and faster pace of steps are manifested by other signs:

• pre-fainting;
• migraine;
• chilling;
• weakness;
• swelling of the face;
• loss of sensitivity in fingers;
• inability to navigate in space.

The combination of such symptoms with vegetative-vascular dystonia suggests immediate seeking medical help.

Recommendations on how to normalize blood pressure, prevention

To stop blood pressure surges while moving, you should stop, catch your breath and change the speed of movement. Then, together with the attending physician, develop behavioral tactics. It is necessary to determine whether secondary or primary hypertension is provoked by movement. This will confirm or refute the increase in cardiovascular parameters, its systolic, diastolic or mixed nature, as well as complete clinical and laboratory testing of the patient.

If the diagnosis is established, the doctor will select an individual program for correcting the pathology using medications and other methods of therapy. In this case, you need to focus on certain rules in order to avoid the negative consequences of walking:

• move only measuredly, slowly;
• do not forget about the ban on sports or other walking without consulting a doctor or appropriate preliminary training;
• Walking every day is a natural workout for the cardiovascular system;
• gradually increase the load;
• move, periodically stopping and resting;
• the patient must know that a sharp deterioration in general condition with dizziness, visual and auditory disorders is a sign of a pre-stroke;
• Physical activity is contraindicated for pregnant women; it tones the uterus and can cause miscarriage or premature birth;
• taking antihypertensive drugs simultaneously with changes in blood pressure indicates incorrectly selected therapy or a minimum dosage that is not able to control blood pressure.

The correct speed of movement, from the point of view of doctors, is calculated using a special formula: the maximum pulse numbers minus the patient’s full age are multiplied by 0.65. The result is the permissible maximum load.

For example, maximum heart rate is 200. Age 45 years. Difference = 155. Multiply by 0.65, we get 100.75 or rounding, 101 steps. It is believed that 50 steps correspond to a speed of 3 km per hour. This means that we need to walk at a speed of 6 km per hour or cover 3 km in half an hour.

The benefits of physical activity for the body

Moderate loads are necessary for the human body. They strengthen the immune system and help muscles stay toned longer. But in order for sports to bring benefits and not harm, you should approach the exercises competently. First of all, you need to take into account the individual characteristics of the body and choose the most optimal sport. You can entrust this to an experienced trainer or look for options on the Internet, based on personal preferences, the strength of physical activity during training and your own well-being when reacting to classes. Indeed, now in most sections you can attend the very first lesson for free, so that a person can get an idea of ​​whether he will like the chosen sport and whether he will be able to do it.

It has been proven that regular exercise has a positive effect on the state of the cardiovascular system, breathing is stabilized, and tissues are saturated with the necessary amount of oxygen.

Walking in the fresh air is one of the most beneficial types of physical activity. They are not tiring if you walk at a comfortable pace, but they help avoid problems associated with physical inactivity. And time spent in the fresh air reduces the risk of the onset and exacerbation of various chronic diseases, strengthens the immune system and has a positive effect on the condition of the heart and blood vessels. In addition, complexion improves, excess weight goes away, and sleep normalizes. Regular walking for 45 minutes a day significantly improves a person’s general condition. Walking at least 3 km a day reduces the risk of mortality in older men by 1.5 times. To normalize sleep, walking a couple of hours before going to bed is optimal.

In addition, walking is a type of exercise that has the least impact on the joints, so this sport is allowed for almost all people.

Prevention

Anaerobic natural exercise, which includes walking, is the best prevention of hypertension. It invigorates, lifts the mood, and after a few hours leads to a decrease in hypertension. The movement has a cumulative effect; it accumulates its positive effect on the heart and blood vessels over three months. But to consolidate success you need regularity. If you stop training, then after a month and a half there will be no trace of the cumulative effect.

Outdoor exercises promote the synthesis of endogenous vitamin D, which is of particular importance for normalizing blood pressure. To minimize high systolic or diastolic readings, you need to:

• calculate the correct diet with a limit on fried, fatty foods, small portions, and a predominance of fruits and vegetables;
• constantly monitor your weight;
• limit salt;
• exclude alcohol;
• avoid depression.

The rules are quite simple. Compliance with them does not require hyper-effort. But the benefits are obvious.