Exercise methods for patients with hypertension In the prevention and treatment of hypertension, exercise therapy has been recognized as one of the effective antihypertensive measures by the International Hypertension Society of the World Health Organization. So, how should hypertensive patients make and implement a reasonable exercise plan? First of all, we should understand some basic concepts of exercise therapy. Exercise methods, exercise therapy and exercise prescription exercise therapy for patients with hypertension are based on disease diagnosis, condition, functional status, rehabilitation goals, etc. In the form of exercise prescription, determine the appropriate exercise mode and amount to guide patients to carry out exercise training. Exercise prescription consists of exercise intensity, exercise duration, exercise frequency, exercise form and exercise items. Simple as follows: 1. Exercise intensity is the most important part of exercise prescription, which is related to the safety and effectiveness of exercise. There are usually four representations: VO2max, METs, HR and RPE, of which the latter two are commonly used. Heart rate (HR): Heart rate is directly related to oxygen consumption and easy to measure, so it is often used as an index of exercise intensity. The exercise intensity of normal healthy people is set at 70% ~ 85% of the maximum heart rate (220 years old) (equivalent to 60% ~ 80% of the maximum oxygen consumption). For patients, the maximum heart rate is best measured directly by exercise test, and the exercise intensity is generally 60% ~ 70% of the maximum heart rate. The degree of conscious effort is graded (see the table below). This index is the subjective feeling of patients, and it is generally required to be controlled at level 3 ~ 5. Perceived Effort Level (RPE) Level 0 No 6 Strong 1 Very Light 7 Strong 2 Mild 8 Strong 3 Moderate 9 Strong 4 Slightly Strong 10 Strong 5 Strong 2. The duration of exercise is determined by the intensity of exercise and the general situation of patients. Usually, the intensity of exercise with 70% maximum heart rate lasts for 20 ~ 30 minutes. Above this intensity, the duration can be 10 ~ 15 minutes; Below this intensity, it is 45 ~ 60 minutes. 3. The frequency of exercise is the number of times of exercise, which depends on the intensity and duration of exercise. High-intensity, long-term exercise, the number of times can be reduced; Low-intensity, short-term exercise, the number should be increased. Moderate intensity exercise at ordinary times, at least 3 ~ 4 times a week. 4. The form of exercise is dynamic aerobic exercise with large muscle groups and rhythmic repetition. Common forms of exercise include walking, pedaling, going up and down stairs, jogging and so on. There are supported lifting exercises that can gradually increase the lifting load, and supported upper limb resistance exercises, such as upper limb combined trainer and upper limb dynamometer. There are also sports involving both upper and lower limbs, such as swimming and rowing trainers. From the therapeutic point of view, lower limb exercise is more effective than upper limb exercise, and the effect of simultaneous exercise or alternate exercise training of upper and lower limbs is better than that of simple upper limb or lower limb exercise. 5. Warm-up exercise of exercise program: At the beginning of each exercise, first warm up for 10 ~ 15 minutes. It mainly includes two parts: first, low-intensity aerobic exercise, such as walking slowly, aims to raise body temperature and prepare the body, especially the cardiovascular system; The second is muscle stretching and joint activity, which aims to avoid muscle and joint injury during exercise. Sports training: including the following forms: ① continuous type, which means continuous exercise without intermission. ② Intermittent type means that there is an intermittent period during exercise. During the intermission, you can stop exercising completely, that is, take a passive rest, or you can take a low-intensity exercise, that is, take an active rest. (3) circular, that is, several forms of exercise are repeated alternately. (4) Intermittent circulation, which means adding intermittent period in circular motion. Finishing exercise (cooling exercise): At the end of each exercise training, there should be a recovery period, so that the body can gradually return to its pre-exercise state and avoid complications caused by sudden cessation of exercise. The finishing exercise includes low-intensity aerobic exercise, respiratory regulation, muscle stretching, joint activities and so on. , generally lasting 5 ~ 10 minutes. 6. Insist on exercise After a certain period of exercise training has produced results, we should insist on long-term training with low exercise intensity. Studies have found that if you stop exercising for two weeks, your physical strength will begin to decline. If you stop for a few months, the curative effect can disappear completely and your physical strength will drop to the pre-training level. The exercise method of patients with hypertension is suitable for the exercise items of patients with hypertension 1. Walking is mainly lower limb muscle exercise. Regular walking is beneficial to dilate small blood vessels, reduce vascular resistance, lower blood pressure and reduce the burden on the heart. Some experts in China have studied the rehabilitation effect of walking exercise on essential hypertension in the elderly. Among them, the walking group walked for 35 ~ 45 minutes every time for at least 5 days every week, with 100 ~ 120 steps per minute. Blood pressure was measured once a week and followed up for 3 months. Results: The walking group was significantly better than the control group. The symptoms of hyperlipidemia, hyperviscosity, hyperglycemia, headache, dizziness and tinnitus in the walking group were also significantly improved compared with those in the control group. Patients with hypertension generally walk at 80 ~ 120 steps/minute. If you feel less strenuous or feel good about yourself, you can jog. However, it is best to walk and jog alternately. The speed of walking and running can be mastered according to the heart rate. Bull's-eye rate at the initial stage of exercise = (maximum heart rate-resting heart rate) ×40%+ resting heart rate. Gradually transition to × 60% after adaptation. The heart rate measured in actual exercise is consistent with the result calculated by this method, and it can be considered that the purpose of exercise has been achieved. It is advisable to walk 3000 ~ 5000 meters each time. After 3 ~ 5 minutes of exercise or cooling down, the heart rate should return to normal, and the fatigue after exercise should be eliminated within 1 ~ 2 hours. As long as you feel good about yourself after exercise and your heartbeat and fatigue disappear quickly after proper rest, it means that the amount of exercise is appropriate. 2. Tai Ji Chuan's exercise is gentle, with natural posture and relaxed muscles, which can reflexively cause vasodilation and lower blood pressure. Johns Hopkins Medical Research Institute in Maryland, USA published an article in the Journal of American Geriatrics Association in March 2002, saying that Tai Ji Chuan can lower the blood pressure of elderly patients with hypertension. They conducted experiments on 62 people who were overweight, over 60 years old and had high blood pressure. These people were assigned to do aerobic exercise or play Tai Ji Chuan for 3 months, 4-5 times a week for 30-40 minutes each time. Tai Ji Chuan adopts "Yang Taiqi" with *** 13 movements. Three months later, they found that people in the Tai Ji Chuan group "had a similar degree of blood pressure reduction as those who participated in moderate aerobic exercise". The author thinks that many elderly people, especially women, basically don't exercise. These people even regard moderate-intensity and high-intensity exercise as awesome, but Tai Ji Chuan, which can be practiced everywhere, needs neither special clothes nor any equipment. For those elderly people who think that they don't exercise at all, it may be an ideal and suitable sport. Domestic experts believe that for patients with stage II and III hypertension, we can choose some of the most natural and relaxing movements in Tai Ji Chuan and weave them into Tai Ji Chuan exercises, such as "cloud hand", "wild horse mane", "holding sparrow's tail left and right" and "rolling arm". Pay attention to avoid difficult movements such as lower limb independence and kicking left and right. When practicing boxing, try to relax, breathe smoothly and have no distractions. The optimal heart rate is 100 beats/min ~ 1 10 beats/min. After 3 ~ 5 minutes of exercise, the heart rate should return to normal. Yoga, meaning "combination", is a traditional way of fitness in India. This law emphasizes breathing rules and meditation to relieve mental stress and cultivate a person's morality. Some experts have found that the ancient yoga fitness method is helpful to treat hypertension and cardiovascular diseases. Two research groups in Atlanta, USA and New Delhi, India reported their research results in the latest issue of German professional magazine Medical Practice. In Atlanta, scientists divided 84 hypertensive patients into two groups for research. Through comparison, it is found that after 13 weeks, the blood pressure of a group of patients who insist on taking part in yoga fitness is obviously reduced, and their temper is no longer as bad as before. The research team in New Delhi observed 42 patients with cardiovascular diseases in groups of 1 year. The results show that patients who participate in yoga for 90 minutes every day rarely have chest tightness and shortness of breath. Compared with patients who do not participate in this kind of fitness, people who participate in fitness lose weight, the content of cholesterol in blood is obviously reduced, and arteriosclerosis is greatly reduced. Exercise methods for patients with hypertension Reasonable exercise for patients with hypertension Patients with different degrees of hypertension should have different exercise methods and exercises, and each patient should make a personalized exercise plan according to his own situation. For example, patients can adjust the amount of exercise according to their pulse changes and self-feeling before and after exercise. 1 hypertension patients can do normal physical exercise or moderate intensity exercise. Patients with stage 2 hypertension can do low-intensity exercise, such as aerobics, Tai Ji Chuan and walking. Patients with stage 3 hypertension can do qigong exercise and body massage. Exercise focuses on persistence, and the "357 method" can be adopted. "Three" means walking for 30 minutes, 3 kilometers, 1 ~ 2 times a day; "Five", exercise at least five times a week; "Seven" refers to moderate exercise, that is, the intensity of exercise is age plus heart rate equal to 170. At the same time, we should ensure adequate sleep. Encourage to exercise at least three times a week or participate in exercise every day, preferably for 30 ~ 45 minutes each time. Exercise emphasizes the intensity, time and environment suitable for personal physical condition. Strong physical labor or excessive exercise can increase cardiac output, systemic muscle contraction, increase abdominal pressure, and blood is relatively concentrated in larger blood vessels, causing blood pressure to rise and inducing stroke. Patients with hypertension should also avoid strength sports, such as weightlifting and breath-holding exercises. In terms of exercise time, it is emphasized that you should not exercise after meals 1 hour, after drinking, and after bathing. Don't exercise when you feel tired, weak or have a cold. The sports environment should be spacious and bright, relatively quiet, and the air should be fresh and tasteless. It is forbidden to exercise beside the roads with more vehicles. Patients with hypertension should also adapt to the changing laws of nature to protect themselves. You should choose to exercise in the morning and evening in summer. Since late autumn, people's blood vessels will contract due to the stimulation of cold air outside, blood pressure will increase and exercise intensity will decrease. Winter and early spring are the high incidence seasons of hypertension, and it is best not to go out for exercise in cold winter (the temperature is below 5℃). Winter swimming should be avoided. References:

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