October 18, 2011

Too little sleep has been linked with several illnesses. And now a new study shows that quality of sleep can affect your blood pressure.
Most studies focusing on sleep look at quantity of sleep. But a new study conducted by researchers at Harvard Medical School and published in the journal Hypertension is one of the first to look at quality of sleep, and its effects on health. The findings show that the quality of your nighttime snooze can affect your risk for high blood pressure. The study looked specifically at the slow-wave stages of sleep, which represent the deepest hours of sleep. During slow-wave sleep, your brains electrical activity and heart rate slow down, and your adrenaline levels and blood pressure decrease. This nightly fall in blood pressure is a good thing, according to the researchers, and not having it may directly influence daytime blood pressure. While the study used only male participants, Dr. Susan Redline, an author of the study, believes the results would also apply to women who fail to get enough deep sleep. How can you know if youre getting the slow-wave sleep you need? If you wake after seven or eight hours of sleep feeling tired and fuzzy headed, that may be a sign that you need more deep sleep. To improve your quality of sleep, try these tips from Michelle Drerup, PsyD, a sleep psychologist and behavioral sleep medicine specialist at the Cleveland Clinic Sleep Disorders Center: Avoid alcohol, which is known to suppress deep sleep, within four hours of bedtime. Alcohol may make you feel drowsy at first, but once it wears off, it leads to rebound arousal and insomnia. Keep your bedroom cool, dark and, most importantly, noise-free. Exercise during the day (studies show that being more physically active can increase the amount of time you spend in deep sleep at night) but not within three hours of bedtime. If you snore loudly or others notice you gasping for breath while sleeping, see your doctor or a sleep specialist for help. These symptoms (yours or someone elses) can interrupt deep sleep. Having sleep difficulties? Cleveland Clinic Wellness Institute is researching the effectiveness of online-based sleep programs and is looking for participants. Find out how to take part in the study by sending an email toGoToSleepResearch@ccf.org.

You may also want to know: Improve your sleep with our expert guided, online program Exercise for better blood pressure Address stress for better blood pressure

Eating Tips for Better Sleep

By Winnie Yu Published 9/8/2009
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Youre lying there wide awake, your tummy rumbling. Could it be that big burger you ate for dinner thats keeping you up? The after-dinner cocktail? The chocolate cake you couldnt resist? Or are you simply hungry for a late-night snack? Turns out that the foods you eat or dont eat can make a big difference in how well you sleep. Even the timing of your meals and snacks can affect your rest. While noshing on the right foods can nudge you toward sweet slumber, eating the wrong ones can keep you tossing and turning. Heres how you can manage your food for better sleep. Cut the Caffeine If youre having trouble with sleep, try eliminating caffeine from your diet by lunchtime, says Andrea Dunn, RD, LD, CDE, advanced practice dietitian for the Cleveland Clinic. As a natural central nervous system stimulant, caffeine can rev you up, sometimes for hours. Caffeine has a half-life of three to four hours, Dunn says. That means that half the amount of caffeine you have at lunch is still in your system three to four hours later. One study found that poor sleepers metabolize caffeine at a slower rate. Banish the Booze An evening nightcap may wash away the days stressors, but it may also keep you up at night. At first, alcohol enhances the effects of gamma-aminobutyric acid (GABA), a chemical messenger in the brain, which signals you to relax and makes you sleepy. Because the effects are enhanced, the brain cells that secrete GABA stop making so much of it. When the alcohol effects are gone two to three hours later,

your brain is still not synthesizing enough GABA, so you have a relative GABA deficiency that results in poor sleep during the latter half of the night, says Sam Fleishman, MD, medical director of the Sleep Center for Cape Fear Valley Health Systems. Ultimately, you get less sleep. Try Early Bird Dining Nodding off too soon after youve just downed a hefty meal can make it hard to doze off. Lying down slows the digestive process and can send stomach acids involved in digestion creeping back up into your throat, which results in indigestion and acid reflux. It will make you feel uncomfortable and possibly keep you awake, says Joy Bauer, RD, author of Joy Bauers Food Cures. Instead, keep your dinners small. I recommend eating a dinner that has no more than 600 calories and optimally at least three hours before bed, Bauer says. Go Mild, Not Hot Fatty foods linger in the stomach longer during the digestion process, causing the stomach to secrete more acid. The result? Heartburn and reflux, says Beth Czerwony MS, RD, LD, a dietitian at the Cleveland Clinic. The more acid there is, the more uncomfortable you may feel lying down. The same is true for spicy foods, which also trigger more acid production.

Tags: caffeine, alcohol, eating, fatty foods, spicy foods

Calm the Mind Before Bed

By Winnie Yu Published 9/8/2009
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The bills. The job. The kids. Whether youre worrying about finances or fretting over your family, its easy to let a wandering mind keep you from getting the sleep you crave. The mind plays a powerful role in how we sleep, says Michelle Drerup, PsyD, a behavioral sleep medicine specialist at the Cleveland Clinic. A lot of times, it can be worry specific to sleep itself, and we start dreading going to bed. But there are also general worries about life, like work worries or an ill parent. A restless mind can keep you from being as relaxed as you need to be to ease into a good nights sleep. The key is taming your thoughts. Make Time to Worry According to the National Sleep Foundations 2009 poll, almost a third of Americans are sleeping poorly because of concerns about their finances and the economy. If youre one of them, you might want to devote a half hour a night an hour or two before you turn in to the sleep-robbing task of worrying. Thats right, you can spend that time doing nothing but fretting, be it figuring out your finances, laying out what you have to do at your job the next day or pondering problems with your spouse. Write these concerns down on a list, and jot down possible solutions. The idea is, Okay, now Ive already done my

worrying, and Ive got my plans ready, Drerup says. For some people, this is really effective, especially if youre the planning type of person. Say Namaste Doing yoga does more than make you limber; studies show it may also induce sounder sleep. The deep abdominal breathing stimulates the vagus nerve, which runs from the base of the brain through the heart and stomach. Inflating the abdomen on an inhalation and contracting it on an exhalation exerts pressure on this nerve, which in turn slows the heart rate and blood pressure and has a calming, soothing effect on the brain and the entire nervous system, says Peggy Hall, a certified yoga instructor. Studies show that yoga also reduces cortisol, the stress hormone, while increasing levels of gamma-aminobutyric acid (GABA), a chemical messenger in the brain that signals you to relax and makes you sleepy. Set the Stage For some people, relaxation comes easily simply plopping down on the couch can start the process. But for others, it actually takes some effort. To get things started, Drerup recommends doing no work, taking no phone calls and avoiding the computer in the hour before bed. Everything you do in that hour should be relaxing, not stressful or strenuous, she says. You might be better off taking a soothing bubble bath or reading a good book, activities that wont rev you up. Just Relax Those of us who find it hard to unwind may benefit from relaxation exercises such as deep breathing, guided imagery or progressive muscle relaxation exercises. Whether youre taking deep belly breaths, visualizing waves on an ocean or tensing and relaxing your muscles, the goal is the same: to ease you into a more relaxed state. When we get stressed, the sympathetic nervous system goes into alert, Drerup says. Thats the fight- or-flight response. Relaxation activates the parasympathetic nervous system, which does just the opposite. That slows the heart rate and respiration, lowers blood pressure and prepares you for a better state of sleep. Get Zen Learning to let go of troubling thoughts with meditation can soothe even the most agitated mind. To do that, consider mindfulness training. Mindfulness is a form of meditation that involves being aware of your thoughts but not reacting to them or judging them. Research by Jeff Greeson, PhD, a clinical health psychologist at Duke University, found that people who took an eight week course in mindfulness-based stress reduction reported better overall sleep afterwards and woke up less frequently during the night. With mindfulness, the goal isnt to relax or even to suppress the thoughts. The goal is to become more attentive and aware of whatever is happening at the time, Dr. Greeson says. Youre saying, Okay, this is what Im thinking.

To become more mindful, its helpful to redirect your thoughts to your breath by placing your hand on your belly and feeling it rise and fall as you breathe. That helps pull the plug when we start feeling the pull of our thoughts, Dr. Greeson says.

Tags: worrying, restless, mind, relaxation, yoga, meditation, relax, mindfulness, meditation, bre athing

Preparing Your Body and Room for Sleep

By Winnie Yu Published 9/8/2009
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Getting a good nights sleep requires more than plopping down on your bed. In fact, sleep is an active process. While we snooze, we pass through several stages of sleep, each with its own distinct physiological changes. We also alternate between non-REM (rapid eye movement) which serves to restore the body and REM sleep, during which we dream and restore the brain. The time you spend in these stages varies by age, but a good nights rest means the sleep should be continuous and uninterrupted. The urge to sleep is dictated by two natural forces. Our homeostatic sleep drive helps us balance our wakefulness with sleep. It tells us were only good for so many hours of alertness before we become functionally intoxicated, says Helene Emsellem, MD, director of the Center for Sleep and Wake Disorders in Chevy Chase, Maryland, and author of Snooze or Lose. Our circadian rhythm, on the other hand, regulates the timing of our sleepiness and wakefulness. You can thank your circadian rhythm for that daily afternoon slump, for instance. Both forces are highly affected by our habits, our routines and even our exposure to sunlight. So for truly sound slumber, its important to respect these internal drives and do things that gear your body for sleep -some folks call this practicing good sleep hygiene. Heres how you can ensure that youre properly prepped for a good nights sleep. Move That Body A good workout that gets your heart pumping and muscles flexing works wonders on promoting sleep. Regular physical activity makes it easier for you to get to sleep and improves the quality of your sleep. For maximum benefit, avoid rigorous activity three to four hours before bed. Body temperature rises when you exercise, which can make it hard for you to get to sleep. Get Some Sun Exposure to sunlight influences circadian rhythm, which is controlled by brain cells in the hypothalamus.

These cells respond to light and dark signals from our environment, and set off reactions in our bodies to either wake us up or make us sleepy. In the mornings, it triggers the release of cortisol, a stimulating hormone, which raises body temperature. Sunlight is a strong stimulus for wakefulness in humans, says Nancy Foldvary, DO, director of the Sleep Disorders Center at the Cleveland Clinic and author ofThe Cleveland Clinic Guide to Sleep Disorders. So getting sun exposure promotes wakefulness during the day and can help people sleep at night. Darkness, on the other hand, triggers our brains to produce melatonin, a hormone that regulates circadian rhythm and promotes sleepiness. Lose a Few Pounds No doubt about it sleep affects weight and vice versa. Studies have found that people who regularly sleep less than six hours have higher body mass indexes (BMIs). When you dont get enough sleep, youre too tired to exercise. You also have higher-than-normal levels of ghrelin, a hormone involved in appetite control, and lower amounts of leptin, a hormone that puts the brakes on food intake. Without enough sleep, youll be grabbing baked goods with a vengeance and packing on the pounds. But if youre too heavy, it becomes harder to get a good nights sleep. Its a chicken-and-egg thing in terms of not knowing what came first, says Amy Drescher, PhD, a research specialist at the University of Arizona in Tuscon. Less sleep leading to obesity, or becoming obese and then getting less sleep. Breaking the pattern isnt easy. Start by trying to ditch just five percent to 10 percent of your body weight, which is all it takes to begin shrinking fat stores, especially the kind thats concentrated in your belly. Belly fat is associated with snoring, which can lead to disruptions in sleep and if its progressive, to developing sleep apnea, Dr. Drescher says. Even small changes like eating 100 fewer calories or taking a short walk every day can help. Create a Sanctuary Think of your bedroom as your private retreat where you go every night to be renewed. Heres how to turn it into the ideal environment for sleep: Look for a mattress and a pillow that are comfortable. Preferences for bedding vary widely, so be sure to test out a mattress for a good 15 minutes before you buy. Set the thermostat on the cool side. Body temperature naturally falls at night. By keeping the room cool, your body will mimic its surroundings. Darken the room with shades and curtains to keep out light, or even use an eye mask. Darkness helps stimulate the production of melatonin, a hormone that promotes sleepiness.

Ditch the Electronics Clear your bedroom of TVs, computers and any other electronics. These gadgets emit blue light, which like any light, can cause wakefulness at night and disrupt the bodys natural inclination to sleep. Use your bedroom only for sleep (and sex), so you wont associate it with any other activity. Dont Smoke Poor sleep is just one more reason you shouldnt light up. Smokers are four times more likely to report feeling unrested after a nights sleep than nonsmokers. The smokers also spent less time in deep sleep and more time in light sleep. Smoking before bed pumps your body with nicotine, a stimulant that can keep you up at night. It also raises overall body temperature and elevates your heart rate and metabolism all of which will keep you awake. To make matters worse, smokers go through withdrawal when theyre asleep, which disrupts their sleep too. Stick With a Routine It doesnt matter whether you soak in the tub, read a good book or listen to your favorite music, the key is doing the same thing every night, so your body gets the signal that youre prepping for sleep. And okay, we know you want to sleep in on the weekends and make up for the slumber lost during the week. But dont. Get in the habit of waking up and going to bed at the same time every night, even on weekends. Sleeping in on Saturdays and Sundays will only make it hard for you to get to sleep on Sunday night, and youll feel less refreshed on Monday.

Tags: sleep hygiene, exercise, activity, sunlight, weight, pounds, environment, appetite, smoking,routine, rit ual

Address Stress for Better Blood Pressure

By Gini Kopecky Wallace Published 6/30/2010
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We dont all stress out about the same things, but we all stress outabout some things, and when we do, our blood pressure often suffers. For some people, the effect is swift and direct. We get anxious, angry, frustrated or frightened, and our sympathetic nervous system kicks into gear and pours adrenaline, norepinephrine, cortisol and other fight-or-flight hormones into our bloodstream. Our hearts beat faster, our arteries constrict or widen depending on where blood needs to go, and our kidneys retain fluids and salt to increase blood volume. All good when we need to fight or run to defend ourselves or push a friend out of the path of an oncoming car. We can ease up afterward, go Whew! and let our parasympathetic nervous

system take over to slow the heartbeat, relax the blood vessels, lower blood pressure and calm the body down. But its not good when the alarm gets tripped chronically for a long list of reasons: moneys tight, the mortgage is due, youre angry with your partner, youre worried about your kids, you hate your job but youre terrified of losing it. The frequent (or, for some of us, constant) bombardment of stress hormones and other emergency-strength biochemicals can inflame or damage the arteries and cause smaller blood vessels to burst, or to thicken and stiffen to withstand the assault. Your heart muscle can suffer from overexertion. Your whole cardiovascular system is working too hard and eventually your body may simply crank up your resting heart rate and blood pressure in response. Here are healthy ways to hit the reset button, and dial down your blood pressure: Learn (your own) body language. If youre the type who doesnt realize youre tense until the pencil snaps in your hand, pay more attention, says Michael McKee, PhD, a clinical psychologist at the Cleveland Clinics Department of Psychiatry and Psychology and author of Stress and Your Body, And What to Do About It. Practice stopping each time you look at your watch or hang up the phone or check your e-mail, and see how your body is doing. Is your neck tight? Is your stomach churning? Are you clenching your fists? These are all signs that something is making you and your body unhappy. You can do wonders for your body, your blood pressure included, simply by telling yourself, I can leave my body out of this. Breathe! When we feel stressed or angry, we tend to hold our breath, which increases carbon dioxide levels in the blood. Studies at the National Institute on Aging have found that the extra carbon dioxide is associated with a higher risk of sodium-sensitive hypertension. Your remedy: the simple act of remembering to breathe slowly, deeply, from the belly. Slow, deep breathing has a bunch of positive biological effects. It seems to work like exercise for the heart, says Dr. McKee. Thats because it restores something called optimal heart-rate variability, or the difference between how fast your heart beats when you inhale and exhale. You want it to beat just a little faster when you inhale, and breathing slowly from the belly gets you there. It keeps the heart strong, and its associated with feeling calm and good, says Dr. McKee. Heres how to do it: Put a hand on your belly. If it doesnt move out and in when you breathe, youre not belly breathing. Use a clock with a minute hand to time your breaths. Aim for six breaths a minute, 10 seconds a breath. Inhale slowly for three or four seconds (your belly should expand, or push out). Exhale (your belly should fall, or push in) more slowly for six or seven seconds. Pause and repeat. Keep it up until you feel yourself relax.

Enhance the effect: Clear your mind of worried thoughts and deepen your relaxation by repeating a soothing word to yourself with each exhale (such as one, peace, love, life, healthy) or imagining yourself in a tranquil setting (your cozy bed, a sun-drenched beach). Conjure a beautiful image to focus on, or see the smiling face of someone you love. Tell yourself, My muscles are relaxing and my heart is slowing. Or visualize your blood vessels widening, your blood flowing well and your blood pressure going down.

Perfect your technique: Do a few minutes of belly breathing as many times during the day as you like. Try to fit in a 15-minute session early and late each day to build your skills. Clearing your mind isnt easy at first. If youre new at it, just try to notice when you get sucked back into your thoughts, tell yourself, I can think about that later, let the thought float off, and return to your focus. Dont be discouraged if you have to do this a lot at first, says Dr. McKee. Youll improve with time. Observing our thoughts also helps us see how unnecessarily stressful (This is a disaster!) many thoughts are, which can help blunt their effect.

Look on the bright side. A study in Circulation found that optimistic women had lower rates of high blood pressure, coronary heart disease, diabetes and death than pessimistic women. Researchers arent sure whether a positive outlook motivates us to take better care of ourselves or has direct health benefits. Either way, being upbeat has upsides for your health. If you tend to see the glass as half-empty, try this: Once a week for a month or more, list three things youre grateful for and spend time contemplating what makes them possible, suggests Thomas Morledge, MD, of the Center for Integrative Medicine at the Cleveland Clinic. Thankful for your health? Think about what keeps you healthy. Thankful for a strong relationship? Think about how you manage that. Evidence suggests that this simple act to cultivate gratitude can be a powerful antidote for anxiety and depression.

Turn to Mother Nature. Something got your blood boiling? Go for a drive in the country. Take a walk in the park. Sit on your back porch and gaze at the grass, trees and sky. Feel better? Of course you do. Its called the biophilia hypothesis, and it holds that, having evolved in nature, we humans are programmed to relax in soothing, savannah-like settings. Our sympathetic nervous system powers down, our parasympathetic nervous system powers up, our heart rate slows, our muscles relax, our blood vessels dilate, and our blood pressure falls.

Laugh a lot! Researchers at the University of Maryland found in a 2005 study that when people watched a movie clip that made them laugh, their blood vessels dilated. When they watched one that made them anxious, their blood vessels tightened up. The researchers werent sure why, but the change in blood flow was marked enough for them to conclude that 15 minutes of laughter a day is probably good for the vascular system. Now, researchers at Californias Loma Linda University report that people with type 2 diabetes who watched

something that made them laugh for 30 minutes a day were much healthier a year later than those who didnt. Tags: stress, blood pressure, blood vessels, sympathetic nervous system, parasympathetic nervous system, biofeedback, bellybreathing, relaxation, gratitude, relationships, oxytocin, nature, laughter

Healthy Eating for Better Blood Pressure

By Gini Kopecky Wallace Published 6/30/2010
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Youve probably heard this before, but theres no getting around it: What you eat can have a major effect on your blood pressure, for worse or for better. In fact, research shows that healthy eating well get to what that means in a minute can lower your blood pressure and keep it there. Whats more, a blood-pressure-friendly diet doesnt have to be an exercise in deprivation. In fact, it can be downright delicious. One of the best-known eating plans to fight blood pressure is DASH, or Dietary Approaches to Stop Hypertension. Developed by the National Heart, Lung and Blood Institute and tested on thousands of people with hypertension, DASH has been shown to help bring blood pressure down to healthy levels. The basics of the plan are exactly that basic, and similar to what youll see in other hearthealthy eating plans such as theMediterranean diet. DASH uses lots of whole grains (seven to eight servings a day); lots of fruits and vegetables (four to five servings a day, each); moderate amounts of nuts, seeds, legumes and low-fat or nonfat dairy; and small amounts (three ounces daily, maximum) of lean meat, poultry and fish. DASH is lower in fat, cholesterol and sodium than the typical American diet, and higher in potassium, calcium and magnesium nutrients that protect against hypertension. You can find more information on DASH as well as sample recipes here. And you can make your diet more blood-pressure friendly, starting today, with these easy steps: Number 1: Halt the Salt Or at least cut back. If you do only one good thing for your blood pressure, you should consume less sodium (a main ingredient of salt), says Steven Nissen, MD, chief of cardiovascular medicine at the Cleveland Clinic. Heres why: If your blood pressure is high or rising, youre probably salt-sensitive. That means your body does not process sodium well. Eating too much throws off the complex interlocking

mechanisms that regulate your blood pressure and blood volume, which leads to a slew of problems: your kidneys retain fluid, your blood pressure and blood volume increase, and your blood vessels can get damaged in ways that contribute to chronic hypertension. Eat less salt and your blood pressure may fall fast, too. A study in Hypertension found that switching people with resistant hypertension (the kind that doesnt respond to drugs) from a high-salt diet to one low in salt brought their blood pressure down an average of nearly 23 points in just a week. Health experts recommend that you eat no more than 1,500 mg of sodium daily the equivalent of teaspoon of salt if you have high blood pressure or pre-hypertension. If you dont, limit yourself to 2,300 mg. On average, American men consume 3,100 to 4,700 mg of sodium a day, while women consume 2,300 to 3,100 mg. Sodium is present in almost all foods, so its easy to load up even if you never sprinkle salt over your plate. For example, a fast-food burger can top 1,000 mg of sodium. A dill pickle: 928 mg. A cup of tomato juice: 878 mg. But dont get discouraged. Eating fresh and unprocessed foods, simply prepared, knocks down your sodium consumption by a lot. An apple has 2 mg. A potato: 5 mg. One-half chicken breast: 69 mg. A glass of water: 12 mg. For a blood-pressure-friendly dinner, throw together a simple salad, broiled or grilled chicken, and a baked potato topped with low-fat yogurt and chives. Other sodium-saving steps:

Buy low-salt or salt-free varieties of favorite foods. The sodium savings can be big. If you switch to the no-salt version of a popular 1 percent milk-fat cottage cheese, you cut your sodium intake from 360 mg to 50 mg per cup serving.

Get the facts. Manufacturers use labeling gimmicks to convince you that a product is healthful. Even the term less sodium can be misleading less than an awful lot can still be too much. Read the nutrition facts panel, says Mira Ilic, MS, RD, LD, a clinical dietitian at the Cleveland Clinic Wellness Institute. If its more than 400 milligrams of sodium per serving, you should consider it a highsodium food.

Be picky about potassium. Some food manufacturers are adding potassium to high-sodium products to help counteract sodiums effects. Thats good in a way increasing potassium is protective. But a high-sodium food is still a high-sodium food, and there are much more healthful ways to get potassium. Good sources include bananas, cantaloupe, broccoli and pinto beans, says Ilic.

Curb condiments. It may surprise you to learn that two popular brands of ketchup contain 190 mg of sodium per tablespoon. One high-end mustard brand has 120 mg per teaspoon. Seasoning powders, barbecue sauces and soy sauce can also be sky-high in sodium. Look for sodium-free seasonings. Better yet, try nutrient-rich herbs and spices such as oregano, thyme, tarragon, basil and dill.

Number 2: Go Easy on Meat Cutting back on salt is a great beginning, but salt isnt the only culprit in high blood pressure. Eat that fast-food burger and 15 minutes later your blood vessels wont be widening, or dilating, as well as they should. Researchers suspect this is an inflammatory response triggered by the saturated fat. The result: Your blood vessels cannot relax and they become more resistant to blood flow, both of which elevate blood pressure. Burgers, and animal protein in general, cause other biochemical reactions that can inflame blood vessels, further diminishing their ability to relax. Thats why DASH emphasizes lean meats, chicken and fish in small portions and ideally no more than two or three times a week. Number 3: Beat the Sweets The added sugars (glucose, sucrose, fructose) in soft drinks, candy, cookies and muffins can also cause a low grade of inflammation in your body, which can affect your blood vessels. Research over the past decade has pointed toward inflammation as being the trigger that causes most forms of coronary heart disease. Americans consume an average of 22 teaspoons of added sugar a day; the American Heart Association recommends a maximum of six teaspoons for women and nine for men. Drink club soda instead of a 12-ounce cola and you eliminate eight teaspoons right there. (And a bonus: You get a big sodium savings!) Number 4: Eat Those Magic Minerals Along with potassium (mentioned above), magnesium and calcium are the go-to nutrients for keeping your blood vessels healthy and working properly. Almonds, cashews, spinach, oatmeal and baked potato with skin are good sources of magnesium. For a calcium boost, try low-fat or nonfat plain yogurt, salmon, tofu and sardines.

Tags: Mediterranean diet, fat, cholesterol, potassium, calcium, magnesium

Exercise for Better Blood Pressure

By Gini Kopecky Wallace Published 6/30/2010

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Move it! Thats one of the best things you can do to lower your blood pressure. Which makes sense, when you think about it: The key to managing hypertension is to get your blood vessels working well and your blood flowing the way it should. And what gets that blood flowing better than exercise? Aerobic exercise, including walking, jogging, cycling, swimming and other sustained, rhythmic activities, brings the best blood-pressure lowering results, says Gordon Blackburn, PhD, director of the Cardiac Rehabilitation Program at the Cleveland Clinic. The reasons:
It gets your heart pumping blood to your muscles. This may cause a slight rise in your systolic pressure the top number in your blood pressure reading, which measures the pressure in your arteries when your heart contracts and pumps blood. But aerobic exercise also causes a drop in your diastolic pressure, the bottom number, which measures the pressure when your heart relaxes and refills. When you finish your walk or workout, your systolic pressure comes down and your diastolic pressure remains low, with the net effect that your overall blood pressure is reduced, says Dr. Blackburn. It burns calories. This helps you control your weight, which is important for managing blood pressure. It makes your heart stronger and more efficient. The heart pumps more blood with each contraction so it doesnt have to contract as often. This brings down your resting heart rate along with your blood pressure. It gives your blood vessels a healthy workout. The lining of the arteries, called the endothelium, is a major determinant of the relaxation properties of blood vessels. These properties are important in blood pressure regulation. Exercise stimulates this lining to produce antioxidants that have a positive effect on your blood pressure.

Work (Out) for Rewards Make aerobic exercise part of your routine and you may see your blood pressure drop enough to keep you off medication, if you have borderline hypertension, and to keep your dose low if youre on meds. But these benefits dont come free. You have to earn them. Heres how: Get your heart rate up. Three ways to tell if youre doing it right:

Monitor your pulse. Start with 220 and subtract your age. Thats your peak heart rate. Your goal is to get your heart beating at 60 to 70 percent of that rate. If youre 40, youll aim for 108 to 126 beats a minute.

Pay attention to how you feel. Are you sweating? Huffing and puffing? On a scale of 0 to 10, with 0 being hardly working and 10 being pushing yourself to the limit, where are you? From 3 to 5, youre in the zone.

Take the talk test. If you cant talk at all, youre working too hard. If you can sing, youre going too easy. If you can carry on a conversation without gasping, youre in the right place.

Keep your body thrumming at this level for about 30 minutes, at least three times a week. But thats your goal, not your starting point, says Eduardo Ortiz, MD, MPH, senior medical officer and program director of the National Heart, Lung and Blood Institute Hypertension Guideline Program. Your best starting point: Whatever gets you going. Walk around the block each morning, swim a few laps or take a folk-dancing class. You might enjoy it and decide to do more. Stick with it. If you hang in long enough to see benefits and then slack off, your blood pressure will climb back up, says Dr. Blackburn. So find an activity you really like never mind what anyone else enjoys doing. Ask yourself: Is this something I can see myself doing a year from now? If not, try something else

Tags: blood pressure, systolic, diastolic, hypertension, aerobic exercise, heart rate, peak heart rate,talk test, perceived exertion, pulse, pedometer