Hypertension (high blood pressure) affects about 50 million individuals in the United States and about 1 billion worldwide. It is the most common diagnosis, associated with 35 million office visits and a risk factor for heart disease, stroke and renal failure.

Blood pressure is the force of blood on the vessels of the circulatory system. It is expressed as two numbers: the top number (systolic pressure) is the pressure in the vessels when the heart is beating. The bottom number (diastolic pressure) is the pressure when the heart is filling and relaxed.

Hypertension is defined as a blood pressure reading of 140 over 90. New guidelines established in 2003 have a new classification category called “pre-hypertension” defined as a reading of above 120 over 80.

Lifestyle changes including weight reduction, dietary sodium reduction, physical activity and moderation of alcohol consumption are cornerstones of treatment for hypertension and pre-hypertension.

Research shows the benefits of exercise for people with both hypertension and diabetes. However, most studies focus on outcomes for blood glucose control rather than heart health. The National Institute of Diabetes and Digestive and Kidney Diseases is sponsoring a clinical trial to evaluate the impact of exercise on heart health for individuals who have type 2 diabetes as well as hypertension. This trial is currently recruiting subjects.

For more information about the clinical trial, visit their Web site at www.clinicaltrials.gov.

For people with both hypertension and diabetes, exercise provides many benefits including improved heart function, reduced body fat, increased muscle mass, increased insulin sensitivity and reduced blood pressure.

General exercise recommendations for someone with both hypertension and diabetes include:

• Warm up and cool down for five to 10 minutes, and include stretching in your cool-down.
• Walk, cycle or swim at 55 percent to 79 percent of your maximum heart rate (roughly calculated as 220 minus your age), or 50 percent to 60 percent if you are just starting to exercise, at least three to four times per week or more often if weight loss is necessary.
• Resistance training should be done two times per week for 20 minutes; perform one set for each of 8 to 10 exercises.
• Monitor your blood glucose and blood pressure levels with exercise.