By: Paul Schembri | 19/09/2013

‘Hypertension’ (or high blood pressure) is becoming a familiar condition that presents itself in many Pilates studios and can often be a precursor to Cardio-Vascular Disease (CVD): both conditions can seriously affect the client and it is important within the Pilates studio that programs are specifically tailored and designed to address hypertension in order to avoid further stress on the body. Hypertension can affect 1 in 7 adults – particularly those age 45 and over, though it is more common in men – and is often called ‘the silent killer’ as generally, it often does not present obvious symptoms for many years until it reaches high levels and thus causes damage to certain organs.

What is Hypertension?
When the body is physically challenged, the heart is forced to work harder and increases the blood pressure (BP) through the arteries. Blood pressure, when measured, is usually presented as a figure above another figure i.e. the systolic (heart muscle contraction) pressure over the diastolic (the relaxation of the heart muscle between beats) pressure. Normal ranges are defined as 90-120mmHg (millimetres of mercury) over/above 60-80mmHg. ‘Pre-Hypertension’ is defined when the pressures are 120-139mmHg over 80-89mmHg; ‘Stage 1/Grade 1 Hypertension’ is when pressures are 140-159 over 90-99mmHg; ‘Stage 2/Grade 2 Hypertension’ is defined as 160-179 over 100-109mmHg and ‘Severe/Grade/Stage 3 Hypertension’ is the label given when blood pressure is 180mmHg over 110mmHg or more.

What causes Hypertension?
There can be many reasons for increases in BP. ‘White coat Hypertension’ is the label applied when the patient is in the Doctor’s room and may feel nervous or anxious as the test is taking place and therefore may give a false reading. Pregnancy may also affect BP as the body undergoes many physiological changes as the pregnancy progresses. While hypertension may exist prior to pregnancy, it can be something that develops. Either situation is cause for concern as it may be an early warning sign of Pre-Eclampsia. This may be accompanied by headaches, vision loss, vomiting, epigastric pain and edema. If this and/or high BP is left unchecked, this could develop into Eclampsia: a hypertensive emergency.

When such pressures are high, there is an increased risk for the client towards stroke, heart attacks/heart failure, aneurisms and a lower life expectancy. With such high pressures, sometimes there may be symptoms such as dizziness, headaches (particularly at the back of the head), vertigo, tinnitus, shortness of breath and/or nausea or vomiting.

How is it treated?
When a diagnosis has been made, medications may be prescribed to assist in lowering blood pressure. Often however, the first line of defence are major lifestyle changes, generally being to avoid cigarette smoking, salt and fat; keep alcohol intake at small, moderate levels; have your BP checked and monitored regularly and to try to encourage a stress-free life i.e. incorporate relaxation techniques and to lead an active lifestyle.

How can Pilates help?
Clearly, this is where Pilates can be of most assistance (also walking, running, cycling, Tai Chi and swimming) – indeed any physical activity which is rhythmical, dynamic, isotonic (not static), aerobic and of a moderate intensity i.e. where the heart is exercised at 40-60% of maximum heart rate that can be built upon. This level of work should still allow the participant to converse with a slight challenge to the breathing rate. Resistance training to retain muscle mass and performed at a slow to moderate speed through full ranges of motion without holding the breath become important. Pilates, with its’ use of spring resistance and pulley systems has a wonderful focus on working muscles both concentrically and eccentrically (strengthen whilst lengthening). Pilates exercises are designed to assist us in our everyday life, working the body through full ranges of motion that are very similar to everyday activities, from bending over and picking up/putting on one’s socks through to reaching up into high cupboards or lifting heavy loads. Whilst there may be initial concerns about exertion/over exertion – particularly from a formally sedentary client, the benefits of physical activity far outweigh the risks and place a greater importance on participating in well-supervised sessions with a well trained instructor in a supportive and safe environment. Exercises to avoid are ones that involve static/held positions for long periods of time and also those exercises which require inversion i.e. legs and feet being higher than the heart.

Undertaking the appropriate training program can actually lower BP by 5-7mmHg and can last up to 22 hours afterwards. This is known as P.E.H: Post exercise hypotension. Pilates, done on a regular basis, also assists in keeping the arteries elastic, thereby keeping the blood flowing and reducing BP.

An added – and important – element in Pilates is the use of breath. In general, we intuitively understand the importance of breathing: “Take a breather” or “breathe deeply, count to ten and calm yourself”. In a Pilates session, all movements are coordinated with breath. Not only does this assist the rhythm, flow and pace of your workout, it also promotes better lung capacity; elasticity in the muscles and fascia of the body, thereby ensuring better blood flow and oxygenation. Breathing also facilitates relaxation and stress release and minimises overwork/tension patterns in the body, allowing the joints of the body become open and actively stable (not locked and rigid).

For more information about Pilates and Hypertension, please feel free to contact the staff at Infinity Pilates, either by phone: (03) 9534 6233 or by email: info@infinitypilates.com.