A study that proves the influence of exercise on high blood pressure was conducted as follows: People with high blood pressure were divided into two groups.

One group, the experimental, did supervised aerobic exercise daily in a one-hour session; the other group, the controls, were told to continue their normal daily routine. People were paired by weight, height, and family background.

Both groups were given precise doses of medication to keep their blood pressure at 120/80. The objective was to monitor any changes in medication requirements. Within a month, the medication requirements disclosed the power of regular exercise.

The medication required by the exercise group had declined by 20 percent at the end of four weeks and 30 percent by six weeks. The medication required by the control group had increased by 5 percent during the six-week period.

This confirms what is consistently observed in the population at large: People who exercise regularly have lower blood pressure and are much less likely to develop high blood pressure.

Moderate regular exercise improves cardiac output, reduces blood pressure, and increases lean body mass. Many studies have shown that regular exercise, for six or more months, reduces blood pressure by about 9 percent. Improved cardiac output means the heart pumps more blood with each beat.

In other words, regular exercise improves the pumping efficiency of the heart by making it a stronger muscle, just as weight-lifting builds big arm muscles. Now that shouldn’t surprise you; after all, the heart is a muscle, and how do you improve the strength and flexibility of any muscle?

Exercise, that’s how! Every study confirms that moderate exercise must be done regularly and steadily. Regularly means about five times weekly or more.

Moderate means that it has to be vigorous enough and long enough each time to have an effect—you need to sweat a little—but not so vigorous that you are constantly sore or exhausted.

That translates to vigorous walking for about forty to fifty minutes daily or jogging twenty to thirty minutes. There are many other forms of exercise that work as well or even better, and we’ll explore them as alternatives. When I say exercise reduces blood pressure by about 9 percent, that’s an average.

In a recent study reported in the Journal of the American Medical Association, the reduction amounted to 13 percent or more in some individuals, but on the average was about 9 percent.

You can do some quick arithmetic to see that a 9 percent reduction will take some people from the high blood pressure category (135/95) to the high normal category (123/86).

If you combine exercise with the dietary guidelines, you can considerably improve your chances of keeping your blood pressure down. But you’ve got to exercise regularly, and it takes time for the results to become apparent.

Aerobic Versus Anaerobic

Aerobic means “with air”; anaerobic means “without air.” Anaerobic exercise is a slight misnomer: you usually, but not always, breathe when you do anaerobic exercise. But, though anaerobic exercise elevates your general metabolism, it doesn’t exercise your heart and arteries.

Anaerobic exercise is usually short in duration, even if quite vigorous. Your body performs almost without the need to breathe. For example, swimming under water the length of a forty-foot pool, though vigorous exercise, is definitely anaerobic because the energy used during the swim comes from energy-yielding substances within the body.

Running a 100-yard dash is also anaerobic. Although it sounds strange, the runner could conceivably run holding his breath. Other examples of anaerobic exercise are weight-lifting, some track events (shot put, discus throw), and everyday activities like running for the bus.

Walking, running, swimming, and cross-country skiing, when done for at least twenty minutes and up to an hour daily, are all aerobic exercises because they involve prolonged use of the cardiovascular system to move large amounts of oxygen in the blood to the entire body.

They tone the entire cardiovascular system. Anaerobic exercise, in contrast, doesn’t rely on prolonged use of the cardiovascular system. Anaerobic exercises should be avoided because they temporarily raise blood pressure and, when done regularly for a long period of time, may keep pressure permanently elevated.

You know these types of exercise don’t help because they create an oxygen debt that has you gasping for breath when you stop. If you can’t do it for at least twenty minutes, then don’t do it at all. Which aerobic exercise is best for you?

Most people can take a long brisk walk, jog, cycle, or swim. Nowadays, there are devices available to be used at home or in gyms that simulate just about every type of exercise. Exercising for the times given will burn about 300 calories.

The best time of day to exercise is open to debate: Physiology gives the edge to the end of the day and sociology to the beginning of the day. Exercise not only tones the body, it relieves stress and tones the mind.

Stress for most people is usually highest at the end of the day, so exercise then helps the mind as much as the muscles. Early morning exercise, however, provides a different advantage.

Any time you exercise, your brain produces natural opiates called endorphins, which elevate your mood. Although they help you feel better after the day is done, they can also help you start the day with an optimistic outlook.

Sociologists have learned that people who exercise in the morning are less likely to quit their exercise program because most people have more control of the early morning hours before the day’s obligations take over.

All you have to do is rise earlier and get started. Most studies also have shown that morning exercise makes you more efficient during the day. But whatever time of day you choose, the important thing is to exercise. No one is so unfit, so overweight, so physically handicapped that she can’t exercise.

I have had the beautiful experience of seeing women in their early eighties start an exercise program to help their arthritis. My own mother, at eighty-two, mounted a stationary bicycle each day and peddled for twenty minutes. If she could do it, so can you.

There’s an exercise available to everyone just as there are excuses available to everyone.

• “I don’t have time.” Baloney! Nothing is as important as your health, but nothing is so easily avoided as changing your habits. You’ll just have to get up earlier or stop work earlier. Time can be found if you want it!

• “It’s dark and dangerous in the early morning or early evening!” No excuse! The plethora of excellent indoor exercise devices available today that have been tested and proven effective make it possible to never go outside.

• “I’m so out of shape it’ll take too long.” No excuse. It doesn’t take as long to get into shape as it took to get out. Start slowly and work up. Walking thirty minutes at a vigorous pace each day is a good start, and it doesn’t even require special shoes, except ones that won’t cause blisters. Then, work up to fifty minutes, and you’re on your way.

Before anyone with high blood pressure starts an exercise program, he should get the go-ahead from his physician. Ask your doctor if it’s okay for you to start a moderate aerobic exercise program.

Explain that you’re going to start slowly, for example, a walking program, and work up to something more active. The doctor will explain any restrictions, but it’s a rare doctor who will say no to vigorous walking unless your condition is exceptionally serious.

Maximum heart rate is the maximum beats per minute you should achieve for your age. Most doctors won’t allow you to achieve this rate during an exercise physical unless they must for some specific technical purpose.

You can easily determine your maximum heart rate—just subtract your age from 220, then take 70 percent of that number, and you’ve got the training heart rate (THR) you should strive for in exercising. An ideal exercise will get your heart rate (pulse) to that figure and maintain it for twenty to thirty minutes.

By exercising for twenty minutes, three or more times weekly, you can achieve a training effect. A training effect stresses the cardiovascular system sufficiently so it responds by slowly building more capacity.

In the long run, the heart pumps more efficiently, more capillaries develop, and the muscles around the arteries become stronger. Achieving 70 percent of maximum heart rate for twenty minutes is an optimum combination.

Take a typical fifty-three-year-old man: his maximum is 167 (220 – 53), and his THR is 70 percent of 167, or 117. So he should exercise vigorously enough to get his heart beating within 10 percent of his THR; that’s from about 110 to 123.

When you start out, stay at the low end. After you’ve been exercising six to twelve months, go nearer the high end. You should not go more than the THR, unless a physician approves or recommends it. You can stay below 70 percent, however, if you extend the exercise time.

For example, twenty minutes of jogging at 70 percent equals about fifty minutes of vigorous walking at 50 percent. You can achieve a training effect by simply putting more time into a lower level of activity.

In contrast, don’t try the reverse; that is, exercise at 120 percent or even 130 percent of your THR for less time. In our example, it would mean the fifty-three-year-old man exercised to a heart rate of 140 or 150 for about ten minutes.

Not only can such behavior damage your heart, it will actually have a negative effect. Stick with what the experts have proven and you’ll succeed. The THR is an average, and you should probably fall somewhere within that range.

Just as humans vary in their appearance, so they vary right down to each of the 50 trillion cells that make up the average 150-pound person, and this variation extends to each person’s training needs as well.

But on average, if you start an exercise program that your doctor says is okay for you, you should be able to achieve your normal THR after a month or two. Suppose you start with a resting pulse of about 80 or more. Then you’ll reach your THR more quickly and have to be more moderate than others.

But as you become more fit, your resting pulse will become lower. Suppose you can’t exercise fast enough to get to your THR. For example, you have a heart problem that prohibits it.

No problem. The THR is an objective that makes it easier because, if exercise is done at a THR for twenty minutes, three to five times weekly, it achieves the training effect.

It’s a kind of optimum between time spent and level of activity. You can get the same result at a lower level of activity done for a longer period of time. For example, suppose you can get about halfway to your THR from your resting pulse.

That’s okay. Simply do it about two and a half times as long. So, instead of jogging twenty minutes, walk briskly for fifty minutes. It’s that simple. I emphasize two and a half times because the trade-off is not direct.

A little more time is required at the less vigorous level, but the result is the same. I urge you to start a walking program. Walking is easy, doesn’t require anything special beyond good shoes, and you get to see things along the way. Just don’t stop and talk!

Many other variations of exercise are also excellent. As long as the exercise gets you to your THR, and you can sustain it for twenty minutes or more, it is fine. That opens up many possibilities. See below for a list of suggested exercises.

Other possibilities are listed below:

Aerobics (low and high impact)
Skating (ice and roller)
Jazzercise (also called Dancersize)
Tennis (vigorous)
Racquetball
Handball
Water polo
Basketball
Hockey

Notice I’ve left out golf and weight-lifting and specified that tennis should be vigorous. The reasons for these restrictions illustrate what you’re trying to accomplish, and it’s worth reviewing again.

Golf is a great way to ruin a walk. You walk a little, stop to plan your next shot, talk, wait for others to hit, and so forth. That’s not steady exercise even though it takes the better part of a day.

It may be excellent recreation, but it’s not the way to obtain a training effect. Anaerobic exercise, like weight-lifting or short-distance running, may add muscle mass, but it doesn’t improve aerobic capacity.

That is, it doesn’t cause the heart to achieve its THR and remain there for twenty minutes or more. Tennis usually fits this criterion because of so many frequent stops for most amateurs. If, however, you play tennis vigorously for a long time (many sets) and don’t stop and talk, it will produce a training effect.

One advantage is that you’ll get good at one of the world’s greatest social games and get in shape as well. Many beginner joggers and cyclists soon feel the effects of fitness and become dedicated. They often start slowly and before long the runners enter 10K races and the cyclists start with century runs.

I’ve had many pupils do this with fantastic results and I’m proud of them. But when people ask me what I do, I always talk about my total program that starts with simulated cross-country skiing. Jogging and cycling are excellent for cardiovascular purposes.

But have you ever noticed that although joggers and cyclists develop muscular legs, their shoulders and arms are undeveloped. It’s because the body adapts. If you jog or cycle, you need large muscle mass in your legs, but not in the shoulders.

The same but opposite effect unavoidably occurs in the wheelchair “runner,” whose shoulders and arms become very well developed. This is why I’m a fan of simulated cross-country skiing.

The Nordic Track machine exercises both upper and lower body. It uses both arms and legs and consequently requires some time to get coordinated. The training effect is excellent, however, and the shoulders, arms, hips, and legs become conditioned at the same time.

An added benefit is derived from the twisting effect in cross-country skiing. It comes from moving the left arm and right leg simultaneously, and vice versa. This movement helps reduce the fat pads, or love handles, that so many adults develop around the hips.

In addition to twenty to forty minutes of cross-country skiing, a few other exercises are essential to help improve lean body mass and general conditioning: stretching and toning.

Stretch

Before exercising, some stretching exercises are essential because they help prevent soreness and injury. Stretching the calf muscles and Achilles tendons of the legs is easily accomplished by touching the toes while keeping the feet flat on the ground. A good variation is to cross the feet.

Don’t bounce up and down in an attempt to get closer to the toes; that can hurt and actually damage your tendons. In another variation, stand facing a wall, about one foot away, and lean forward, bracing yourself with your hands. Stagger your feet and bend the forward knee.

Keep the rear leg straight with the foot flat on the floor; you will feel a stretch in the rear leg. The hamstrings of the upper leg are easily stretched by two methods.

While standing, raise one leg about hip high (no higher) and rest your heal on a chair arm or other support; keep your let straight and stretch your arms and try to touch the toes of that foot.

Don’t bounce; a long slow stretch is best. Alternatively, while sitting on the floor with legs apart face forward, clasp your hands behind your back. Slowly lean forward over your left knee.

Try to keep your legs straight. Reverse it leaning over the right knee. Hip stretches are easily done by kneeling on one knee with your back straight; then lean as far forward as possible over the upright knee.

Keep the other knee and foot in position on the floor. Lower back stretching is essential, especially as people get older. Lie flat on your back, pulling one knee at a time to the chest and holding it for about twenty to thirty seconds. After doing each leg about five to ten times, do both legs together and hold for thirty or more seconds.

If you are up to it, there are daily TV exercise programs that emphasize stretching and limbering. Many of them are quite advanced, and you may not be able to keep up. Just get the motion down properly and go at your own pace. Videotapes of slow-paced exercises are also available.

Tone Toning exercises tone muscle groups: a flat stomach, thin thighs, hips without love handles, a firm derrière instead of a soft fat one, and tight arm muscles instead of soft hanging flab. Simulated cross-country skiing is good because it exercises the arms, hips, and thighs all at once, but other exercises help tone, too.

Half sit-ups with knees bent will flatten the tummy; but they take time to be effective, so perseverance pays. For women who cannot do a complete sit-up (often the price for pregnancy), there are devices you can purchase that will provide support.

One device is a harness you wear that has an elastic band that you attach to a door to assist you in sitting up. Others are laced on a hard mat you lie on, it’s hinged with handles at shoulder level that you grip to assist the muscles and make the sit-up easier.

In both types of devices, the stomach muscles get toned. Alternatively, get in a sit-up position and simply lift your head as high as possible each time.

Slowly it will get easier as your stomach muscles strengthen. Whatever type you do, work up to about thirty daily. You will eventually notice a flattening of your stomach and a reduction in hip circumference.

Love handles are dealt with by holding 10-pound weights (books work well) hip high in front with both hands, feet about twelve inches apart. Rotate slowly as far as possible to each side; hold for about ten seconds.

Work up to thirty repetitions on each side daily, and eventually the love handles will disappear. Perseverance is essential. Thighs are thinned by lying on your side and raising the topmost leg; keep both legs straight; reverse sides and repeat.

Start slowly as these can make you stiff and sore, but work up to about twenty repetitions for each leg. Once more, perseverance is required, but results will slowly appear. Use hand weights to firm arms.

You don’t have to purchase anything sophisticated; any household object, such as a book or a paperweight, will do. Lift the weight up slowly and bring it down slowly. Remember, the weight need not be heavy, just do the exercise regularly. You can do this while walking or, if you’re good, while jogging.

Additional Benefits

Exercise is synergistic. Synergism, from a Greek word, means the sum is greater than its parts. Simply put, if you add the benefits of exercise to your dietary program, you get something even greater than you would have imagined. Satisfaction comes with positive reinforcement.

You will begin to find satisfaction as you gain flexibility, burn fat, and develop muscle and discover you can perform tasks you had once thought impossible—such as running 10 miles or bicycling 50 miles. Physical fitness always improves mental alertness because improved muscle tone improves circulation.

Improved circulation brings more oxygen and nourishment to your master organ, the brain. Sleep will be sounder, but not because you are tired; on the contrary, you will have more energy. You will sleep better because every- thing about your body is more efficient.

Although the restorative power of sound sleep remains a scientific mystery, no one can doubt its miraculous mental and physical value. Your bowels will function more regularly, another synergistic benefit of exercise with improved diet.

Although dietary fiber improves regularity and bowel function, regular exercise, which tones all muscles, including those of the bowel, helps them to respond easily and regularly. Bones will become larger and denser.

Osteoporosis is a decline in bone density due in large part to inadequate dietary calcium and exercise during childhood and adolescence. Once women are past menopause, and men get past the age of fifty, hormonal changes accelerate bone loss, so the problem becomes even more critical.

Two factors require personal control: increasing dietary calcium and exercise. Exercise efficiently relieves stress because it provides a convenient means of eliminating the excess flood of hormones, fats, and blood sugars that spill into the blood from the stress.

In stress, the body prepares itself to either stand and fight or to run from the danger. Aerobic exercise after a stressful period will benefit you greatly. That’s why I always urge people in high-stress professions to exercise at the end of the day.

Since their days are often long, this requires indoor equipment, except during long summer evenings. Alternatively, many successful people schedule stressful meetings in the morning and use the lunch hour for a twenty-or thirty-minute jog or a long uninterrupted brisk walk.

If you can’t exercise in the evening or at noon, a morning session still has many benefits. It will condition your cardiovascular system, enabling you to deal more effectively with the stresses of everyday business.