What is high blood pressure?

Blood pressure is the measure of how strongly your blood presses against the walls of your arteries as your heart pumps it around your body.

This number is split into systolic blood pressure and diastolic blood pressure[1].

  • Systolic pressure refers to the maximum pressure within the large arteries when the heart muscle contracts to propel blood through the body.
  • Diastolic pressure describes the lowest pressure within the large arteries during heart muscle relaxation between beating.

If your blood pressure is too high, it may put a strain on your arteries and heart, increasing your risk of a heart attack, stroke and kidney problems.

The good news is that your blood pressure can be brought down to, and maintained at a normal level with lifestyle changes that physiotherapy can help with.

What is hypertension?

Borderline hypertension or high blood pressure is for the adult, a systolic blood pressure between 140 and 159 mmHg or a diastolic blood pressure between 90 and 95 mmHg. While a systolic and diastolic pressure of 160 and 96 mmHg respectively or greater is considered to be absolute hypertension.[2]

Hypertension and its complications (stroke, congestive heart failure, kidney failure and heart attack) are major medical problems all over the world.

High blood pressure can have several causes

Modifiable risk factors include:

  • unhealthy diets (excessive salt, a diet high in saturated fat, low intake of fruits and vegetables)
  • physical inactivity
  • consumption of tobacco and alcohol, and
  • being overweight or obese.

Non-modifiable risk factors include:

  • a family history of hypertension
  • age over 65 years and
  • co-existing diseases such as diabetes or kidney disease.

What will happen when I see a physiotherapist?

Your physiotherapist will work with you to identify what changes in your lifestyle are necessary and achievable. In particular, they will develop a programme of exercise to increase your physical activity safely and effectively.

How can physiotherapy help manage high blood pressure?

Your physiotherapist can advise you about how to lower your risk of developing high blood pressure and also about how to reduce your risk of health problems once you have been diagnosed.

A well-being review delivered by a physiotherapist with knowledge of pulmonary hypertension can identify simple lifestyle changes that can help prevent you having to take medication.

Supervised exercise training has been shown to be beneficial in patients with pulmonary hypertension. exercise in patients with pulmonary hypertension is safe and leads to improvements in functional ability and quality of life.[3]

In particular, your physio can tell you which exercise programmes are suitable for you, depending on how high your blood pressure is, how fit you are and how any other health conditions or disabilities you may have will affect your ability to exercise.

How can I help lower blood pressure myself?

The main advice is to have your blood pressure checked regularly, take regular exercise and eat a healthy diet.

  • Go for a walk every day. Start with short distances and build up gradually.
  • Get advice from your physiotherapist or GP before you start doing more energetic and exercise
  • Stop smoking
  • Lose weight if you need to
  • Eat a balanced diet with plenty of fresh fruit and vegetables and oily fish
  • Reduce the amount of alcohol, salt and animal fat in your diet
  • Take your medication as prescribed.

[1] Shahoud JS, Aeddula NR. Physiology, Arterial Pressure Regulation. InStatPearls 2019 Feb 11. StatPearls Publishing.Available from:

[2] Guidelines Committee (2003) European society of hypertension European society of cardiology guidelines for the management of arterial hypertension. J Hypertens. 21-1011-53.

[3]Leggio M, Fusco A, Armeni M, et al. Pulmonary hypertension and exercise training: a synopsis on the more recent evidences. Ann Med 2018; 50(3): 226–233.

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