How to Train Clients With Hypertension (High Blood Pressure)

How to Train Clients With Hypertension (High Blood Pressure)

Training clients with hypertension (high blood pressure) can open up a new client base for a personal trainer. But, it’s important that you have the proper tools to train someone with hypertension effectively. Using certain personal training software features can help you learn how to train clients with high blood pressure. Find out how to train clients with hypertension in a safe and smart way and learn about what tools you’ll need to train someone with hypertension in this guide by Exercise.com

Get the Basics…

  • Hypertension is a common condition that affects a client’s ability to circulate blood normally.
  • Training someone with hypertension requires greater detail when programming for resistance training.
  • Versatile workout software can help promote performance and safety when training clients with hypertension.

Breaking into training special populations, like training clients with hypertension, can be a rewarding way for personal trainers to add a new stream of revenue to their fitness businesses.

To train clients with hypertension, it’s important that you’re not only well-versed in hypertension, but that you have the tools in place to make your training as effective as possible; that’s where personal training software comes into play.

Dean Somerset - Bird Dog
“Developing an easy intake system with my apps and ways to scale the delivery of workouts has been huge. Working with 20-30 individuals who each have specific goals and restrictions can be challenging, but your platform makes it easy to organize everyone’s programs and put a plan together that will get them the best results possible. The simple, effective tools help expand and simplify my coaching process.”
Dean Somerset
Owner, Somerset Fitness

By taking advantage of the features that personal training software has to offer, you can train clients with hypertension in a way that works for them, not against them.

To learn more about the Exercise.com personal training software platform, book a demo today.

Learning How to Train Clients With Hypertension

To learn how to train clients with hypertension, it’s imperative that you have a thorough understanding of hypertension and why it’s important to follow certain procedures with these clients.

What is hypertension?

Hypertension, or high blood pressure, is a condition in which a person’s blood pressure is abnormally high, usually classified once a person consistently records a blood pressure higher than 130/90. Blood pressure is considered one of the leading modifiable risk factors according to the American College of Sports Medicine (ACSM).

Hypertension is a very common health condition that can often be prevented with a proper diet and regular exercise. Chronic high blood pressure can cause damage to blood vessels and is a risk factor for more serious conditions like kidney disease, heart attacks, or arrhythmias.

Using exercise to fight hypertension is usually a fair plan as long as you use the proper precautions. There could be some differences if you’re training a hypertensive client that’s medicated versus one that isn’t.

In the field of personal training, understanding how to train clients with hypertension is crucial for ensuring their safety and maximizing the effectiveness of their workouts. Hypertension, or high blood pressure, affects countless individuals worldwide and can significantly impact one’s overall health and well-being. In this article, we will delve into the various aspects of training clients with hypertension, including understanding the condition, customizing exercise programs, managing blood pressure during workouts, creating a balanced diet plan, and addressing common concerns and questions.

Understanding Hypertension: Causes, Symptoms, and Risks

Before diving into the training strategies, it is essential to have a comprehensive understanding of hypertension. Hypertension is generally caused by a combination of genetic and lifestyle factors, such as unhealthy diet, lack of physical activity, and excessive alcohol consumption. As a personal trainer, it is crucial to be aware of the signs and symptoms of hypertension, including headaches, fatigue, dizziness, and shortness of breath. Furthermore, it is important to educate clients about the potential risks associated with long-term hypertension, such as heart disease, stroke, and kidney problems.

Hypertension, also known as high blood pressure, affects millions of people worldwide. It is a chronic condition that occurs when the force of blood against the walls of the arteries is consistently too high. This can put strain on the heart and other organs, leading to serious health complications. While the exact causes of hypertension are not fully understood, certain risk factors have been identified. These include age, family history, obesity, stress, and certain medical conditions like diabetes and kidney disease.

Managing hypertension often involves a combination of lifestyle changes and medication. Encouraging clients to adopt a healthy diet rich in fruits, vegetables, whole grains, and lean proteins can help lower blood pressure. Regular physical activity, such as aerobic exercise and strength training, can also be beneficial. Additionally, reducing stress levels through relaxation techniques like meditation or yoga can contribute to better blood pressure control. It is important for personal trainers to work closely with clients and their healthcare providers to develop individualized plans that address their specific needs and goals.

Do you need to be certified to train clients with hypertension?

Before you start creating programs for clients with hypertension, you’ll want to get certified as a personal trainer at the very least. This is important for your client’s safety and to protect you legally. Hypertensive clients may have certain limitations that could be considered dangerous when combined with certain training regimens.

To better prepare yourself to work with clients with hypertension, there are some advanced certifications, listed below.

  • ACSM Certified Exercise Physiologist (ACSM-EP)
  • ACE Medical Exercise Specialist
  • NSCA Special Populations Specialist (CSPS)

These certifications will help you better understand hypertension exercise guidelines so you can start programming for individuals with hypertension safely and effectively.

Training Clients With Hypertension

Working with hypertensive clients isn’t uncommon. If you’re looking to create a workout routine for high blood pressure clients, it does help to know whether those clients are medicated or not. There are a handful of common medications for hypertension that can affect heart rate, listed below.

  • ACE Inhibitors
  • Beta-Blockers
  • Angiotension II Receptor Antagonists
  • Diuretics
  • Calcium-channel Blockers

While this list is not exhaustive, it does serve as an example of the multitude of medications your client could be taking, each of which may impact their blood pressure and heart rate. This means that your client may not experience normal heart rate changes during exercise.

The primary considerations for personal training the hypertensive client surround resistance training. Exercise tends to increase systolic blood pressure, and heavy resistance training tends to exacerbate this effect. Industry professionals suggest that during training, clients with hypertension should avoid holding their breath while resistance training.

In most cases, clients hold their breath while lifting heavy loads or during isometric exercises. In conjunction, these clients may also perform the Valsalva Maneuver. While this technique may help improve lifting capacity, it can increase blood pressure to dangerous levels for hypertensive clients.

There are quite a few exercises that commonly require additional bracing and breathing techniques to be successful in lifting heavy loads. Because of this trend, many professionals consider these exercises to avoid with high blood pressure. Some examples include:

  • Back Squats
  • Front Squats
  • Deadlifts
  • Romanian Deadlifts
  • Olympic Lifts (Cleans, Jerks, Snatches)

It’s important to note that the exercises themselves aren’t of sole concern to clients with hypertension. More importantly, these exercises performed with relatively heavy loads (>80% 1-RM) can be dangerous because of tendencies to strain and resultantly hold your breath.

The top workouts for people with high blood pressure will be aerobic in nature. Aerobic exercise tends to do a better job improving circulation, utilizing energy, regulating fluid balance, and more. Resistance training is still recommended, but simply at lower intensities than you would use with normal clients.

A good measure for hypertensive clients would be to perform resistance training with loads that they can lift 10 times at a minimum. Muscular endurance training would be preferred over muscular strength training.

The Importance of Exercise for Hypertensive Clients

Regular exercise plays a pivotal role in managing hypertension. Engaging in physical activity helps reduce blood pressure, strengthen the heart, improve blood circulation, and enhance overall cardiovascular health. When training hypertensive clients, it is important to emphasize the benefits of exercise and motivate them to incorporate it into their daily routine. Additionally, it is crucial to consider the client’s fitness level, medical history, and any existing physical limitations when designing an exercise program.

One of the key benefits of exercise for hypertensive clients is its ability to promote weight loss and weight management. Regular physical activity helps burn calories and build lean muscle mass, which can lead to a decrease in body fat percentage. This can be particularly beneficial for clients who are overweight or obese, as excess weight puts additional strain on the heart and blood vessels. By incorporating exercise into their routine, hypertensive clients can not only improve their blood pressure levels but also achieve and maintain a healthy weight.

In addition to its cardiovascular benefits, exercise can also have a positive impact on mental health and well-being. Physical activity stimulates the release of endorphins, which are natural mood-boosting chemicals in the brain. This can help reduce stress, anxiety, and symptoms of depression, which are often associated with hypertension. Regular exercise can also improve sleep quality, increase energy levels, and enhance overall cognitive function. By incorporating exercise into their lifestyle, hypertensive clients can experience not only physical but also mental and emotional benefits.

Customizing Exercise Programs for Clients with Hypertension

Each client with hypertension is unique, and their exercise program should reflect their individual needs and goals. When customizing exercise programs, it is important to focus on exercises that promote cardiovascular fitness, such as aerobic activities, walking, swimming, and cycling. Resistance training, including weightlifting and bodyweight exercises, can also be beneficial for improving muscle strength and overall functional capacity. However, it is vital to monitor the client’s blood pressure during exercise and make necessary adjustments to ensure their safety.

In addition to cardiovascular and resistance training exercises, flexibility exercises should also be included in the exercise program for clients with hypertension. Stretching exercises can help improve joint mobility and reduce muscle stiffness, which can be particularly beneficial for individuals with hypertension who may experience stiffness and limited range of motion.

Furthermore, it is important to educate clients with hypertension about the importance of regular physical activity and the potential benefits it can have on their blood pressure management. Encouraging them to engage in activities they enjoy and providing ongoing support and motivation can help increase adherence to the exercise program and overall success in managing hypertension.

Guidelines for Safe and Effective Cardiovascular Training

Cardiovascular training is a cornerstone of managing hypertension, but it must be approached with caution and adherence to safety guidelines. Clients with hypertension should aim for moderate-intensity aerobic exercises, such as brisk walking or cycling, for a recommended duration of at least 150 minutes per week. Gradual progression and monitoring of blood pressure during exercise are paramount to prevent any adverse reactions. Moreover, implementing proper warm-up and cool-down routines is essential for preparing the cardiovascular system for exercise and aiding in recovery.

It is important to note that individuals with hypertension should consult with their healthcare provider before starting any new exercise program. They can provide personalized recommendations and ensure that the chosen exercises are safe and appropriate for the individual’s specific condition.

In addition to aerobic exercises, incorporating strength training into the cardiovascular training routine can also be beneficial for individuals with hypertension. Strength training exercises, such as lifting weights or using resistance bands, can help improve muscle strength and overall cardiovascular fitness. However, it is crucial to use proper form and technique to avoid injury and strain on the cardiovascular system.

Strength Training Strategies for Hypertensive Individuals

Incorporating strength training into the exercise program of hypertensive clients can provide several benefits for their overall health. Strength training helps build lean muscle mass, improve bone density, and enhance metabolic function. However, it is crucial to develop strength training routines that consider the client’s unique needs and limitations. Focusing on compound exercises that target multiple muscle groups, utilizing proper form and technique, and gradually increasing resistance are among the key strategies for safe and effective strength training for hypertensive individuals.

Strength Training Strategies for Hypertensive Individuals

Incorporating strength training into the exercise program of hypertensive clients can provide several benefits for their overall health. Strength training helps build lean muscle mass, improve bone density, and enhance metabolic function. However, it is crucial to develop strength training routines that consider the client’s unique needs and limitations. Focusing on compound exercises that target multiple muscle groups, utilizing proper form and technique, and gradually increasing resistance are among the key strategies for safe and effective strength training for hypertensive individuals.

Another important consideration for hypertensive individuals engaging in strength training is monitoring blood pressure during exercise. It is recommended to measure blood pressure before, during, and after each strength training session to ensure it remains within a safe range. If blood pressure readings exceed the recommended limits, it may be necessary to modify the intensity or duration of the exercise or consult with a healthcare professional for further guidance.

Incorporating Flexibility and Stretching Exercises into Training Sessions

Flexibility and stretching exercises should not be overlooked when training clients with hypertension. These exercises help improve joint range of motion, enhance posture, and reduce the risk of injuries. Implementing dynamic stretches during warm-ups and static stretches during cool-downs can effectively improve flexibility. However, it is important to ensure that clients perform stretching exercises with proper technique, avoiding any excessive bouncing or straining that may increase blood pressure.

Managing Blood Pressure During Exercise: Tips and Techniques

Managing blood pressure during exercise is of utmost importance for the safety and well-being of hypertensive clients. It is crucial to educate clients about the warning signs of abnormal blood pressure responses, such as dizziness, shortness of breath, and chest pain. Encouraging clients to listen to their bodies, take frequent breaks when needed, and perform exercises in a controlled manner can help prevent any potential complications. Monitoring blood pressure before, during, and after exercise sessions can provide valuable insights and enable adjustments to the training program, if necessary.

Creating a Balanced Diet Plan to Complement Training for Hypertensive Clients

Exercise alone is not sufficient for managing hypertension; a balanced diet is equally essential. Collaborating with qualified nutrition professionals, such as registered dietitians, can help create a dietary plan that complements the exercise program and addresses the specific needs of hypertensive clients. Emphasizing a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting sodium, saturated fats, and added sugars is a key component of a heart-healthy diet.

Hydration and its Impact on Blood Pressure: What Trainers Need to Know

Proper hydration is essential for individuals with hypertension, as dehydration can potentially amplify blood pressure fluctuations. Encouraging clients to drink an adequate amount of water before, during, and after exercise sessions is crucial. Additionally, educating clients about signs of dehydration, such as increased thirst, dark-colored urine, and dry mouth, can help them recognize the importance of staying hydrated for optimal blood pressure management.

Monitoring Progress and Adjusting Training Programs for Hypertensive Individuals

Regular monitoring of progress is fundamental when training clients with hypertension. Tracking changes in blood pressure, fitness levels, weight, and other relevant parameters can provide valuable feedback to assess the effectiveness of the exercise program. It enables trainers to make necessary adjustments, such as progressing the exercise intensity or modifying exercises to prevent monotony and achieve optimal results.

Educating Clients on Lifestyle Modifications to Reduce Hypertension Risk Factors

Empowering clients to take control of their health goes beyond exercise and diet. It is crucial to educate hypertensive clients about lifestyle modifications that can help reduce their risk factors for hypertension. Encouraging practices such as stress management techniques, smoking cessation, moderate alcohol consumption, and maintaining a healthy weight can have a significant impact on blood pressure control and overall well-being.

Understanding Medication Effects on Exercise Performance in Hypertensive Clients

Many individuals with hypertension may be taking medications to manage their condition. It is important to understand how different medications can affect exercise performance and adjust the training program accordingly. Some medications may cause side effects such as dizziness or fatigue, which may require modifications to the exercise intensity or duration. Collaborating with the client’s healthcare provider and ensuring open communication is essential to promote safe and effective exercise for hypertensive individuals.

Designing Individualized Warm-Up and Cool-Down Routines for Hypertensive Individuals

Warm-up and cool-down routines are essential components of any exercise program, especially for hypertensive individuals. Implementing proper warm-up exercises, such as light aerobic activities or dynamic stretches, helps prepare the body for the upcoming workout and stabilizes blood pressure. Cool-down exercises, such as gentle walking and static stretches, aid in recovery and gradual return of heart rate and blood pressure to their resting levels. Tailoring these routines to the client’s specific needs and abilities is crucial for optimizing the training sessions.

Promoting Stress Management Techniques for Better Blood Pressure Control

Stress can significantly impact blood pressure levels, and it is crucial to address this aspect when training clients with hypertension. Promoting stress management techniques, such as deep breathing exercises, meditation, yoga, or engaging in hobbies, can be beneficial for blood pressure control and overall well-being. Encouraging clients to incorporate stress-relieving activities into their daily routine can help mitigate the detrimental effects of stress on their cardiovascular health.

The Role of Rest and Recovery in the Training of Clients with Hypertension

Rest and recovery are indispensable components of any training program, and this holds true for hypertensive individuals as well. Adequate rest between workout sessions allows the body to repair and adapt, ensuring optimal results while minimizing the risk of overexertion or injury. Encouraging clients to prioritize quality sleep, incorporate rest days into their training schedule, and engage in relaxation techniques can support the body’s recovery, enhance overall well-being, and contribute to better blood pressure control.

Addressing Common Concerns and Questions from Hypertensive Clients during Training Sessions

When working with hypertensive clients, addressing their concerns and answering their questions is crucial for building trust and ensuring their comfort throughout the training process. Common concerns may include exercise intensity, potential risks, medication interaction, and maintenance of blood pressure control during non-exercise periods. Being attentive, patient, and well-informed allows trainers to provide accurate information, alleviate concerns, and adapt the training program to address any specific needs or limitations.

Training clients with hypertension requires a comprehensive understanding of the condition, meticulous program design, and attentive monitoring. By customizing exercise programs, managing blood pressure, and incorporating lifestyle modifications, trainers can empower hypertensive individuals to take control of their health and achieve improved well-being. Safely guiding clients through their fitness journey and addressing their concerns can ensure a successful and fruitful training experience for both the trainer and the client.

Software Tools for Training Clients With Hypertension

When you’re learning how to train someone with hypertension, you’ll need to be prepared with structured blood pressure-lowering workouts. Your clients will trust and rely on you to provide them safe workouts or exercise guidelines.

Workout Software for Clients With Hypertension

Hypertension can be frightening for those who aren’t familiar with exercise and nutrition. With contraindicated exercises, specific methods of resistance training, and other considerations for exercising with hypertension, your clients might want help understanding how to perform exercise safely.

Exercise.com’s workout software provides trainers with a platform to develop, send, and log workouts that are easily accessed by clients. If your client is away on vacation or doesn’t need your direct supervision, you can even automate their workouts for them to log on their own.

As a trainer, you can even offer a sample exercise program for hypertension clients so they can get a feel for your programming and software. Over time, the software features valuable analytics that comes with easy-to-read graphs and charts.

Fitness Assessments for Clients With Hypertension

Clients with hypertension will exhibit different symptoms or responses to exercise depending on the severity of their hypertension and any associated medications. Exercise.com offers functional fitness assessment software that can help trainers assess hypertensive clients to better understand their abilities.

To prepare for clients with hypertension, you might want to include cardiorespiratory assessments, mobility screens, and muscular endurance tests to get a better idea of how well they tolerate exercise. It’s important to remember that your clients shouldn’t perform a 1-repetition maximum strength assessment due to the adverse effects of high blood pressure.

Once you establish a good relationship and clear expectations with your client, you’ll be afforded greater flexibility with assessments. You can send and automate fitness assessments that clients can conduct and log on their own, as you feel appropriate.

Customizable Exercise Library for Clients With Hypertension

Fitness assessments and workouts are clearly important for hypertensive clients. For clients who are looking to train more independently, you’ll be able to provide your workouts through your custom-branded fitness app with Exercise.com. This offers your clients convenient access to workouts whenever they like.

For clients that might not have a ton of experience in the gym, there is some inherent risk when sending them off on their own. Thankfully, Exercise.com’s customizable exercise library serves as a valuable guide to help clients understand the technique behind every exercise you include in your fitness program.

This way, if your client decides to train independently, you’ll feel confident knowing they can read and visualize the exercise that they’re supposed to perform rather than an unsafe alternative.

Which resistance training is most appropriate for hypertensive clients?

Moderate-intensity resistance training, usually around 50%-70% of one-repetition maximum (1-RM), is generally safe and beneficial for hypertensive clients. It’s recommended to prioritize exercises involving larger muscle groups and perform them in a circuit-like manner to keep heart rates relatively stable.

What kind of exercise would you recommend for your hypertensive patients?

For hypertensive patients, a mix of moderate-intensity aerobic exercise, such as brisk walking, cycling, or swimming, and moderate-intensity resistance training is often recommended. Flexibility and balance exercises can also be beneficial. It’s always important for individuals with hypertension to consult with their healthcare provider before starting a new exercise program.

Which exercise should clients with hypertension avoid?

Hypertensive clients should generally avoid very high-intensity exercises, heavy weight lifting, and any activities that involve holding the breath or straining, as these can cause dangerous spikes in blood pressure.

Can hypertensive patients do resistance training?

Yes, hypertensive patients can participate in resistance training, provided it’s of moderate intensity and they’ve received approval from their healthcare provider. It can help to lower blood pressure over time and offers other health benefits.

Should people with hypertension do resistance training?

Yes, provided their healthcare provider has approved, people with hypertension can and often should perform resistance training. It can help lower resting blood pressure, improve cardiovascular health, and enhance overall physical fitness.

What is the importance of exercise for hypertensive patient?

Exercise is crucial for managing hypertension as it helps lower blood pressure, improves heart health, aids in weight management, reduces stress, and contributes to overall health and wellbeing.

What is the recommended duration of exercise for a beginner hypertensive client?

For beginners, it’s generally recommended to aim for at least 150 minutes of moderate-intensity aerobic activity each week, split into several sessions, and strength training exercises at least two days per week. Starting with shorter durations and gradually increasing as fitness improves is a good approach.

What are the do’s and don’ts of high blood pressure?

Do’s include maintaining a healthy diet, exercising regularly, managing stress, and monitoring blood pressure regularly. Don’ts include avoiding excessive alcohol and caffeine, not smoking, avoiding very high-intensity exercises, and not ignoring regular medical check-ups.

What is a contraindication for people exercising with high blood pressure?

People with severe or uncontrolled hypertension should not start an exercise program without medical approval. They should avoid high-intensity exercises, especially those that involve isometric contractions or Valsalva maneuvers, until their blood pressure is well-controlled.

Should clients with hypertension avoid seated resistance exercises?

Seated resistance exercises can cause a higher rise in blood pressure compared to standing exercises. While they’re not strictly contraindicated, they should be performed with caution, especially for those with poorly controlled hypertension.

When is it appropriate to begin resistance training in hypertensive patients?

Once a hypertensive patient has received clearance from their healthcare provider, they can start resistance training. It’s usually advisable to start with lower intensities and gradually progress as fitness improves and blood pressure stabilizes.

What percentage of the 1 rm is most appropriate for resistance exercise for hypertensive clients?

The American College of Sports Medicine suggests hypertensive individuals perform resistance exercises at a moderate intensity, which is approximately 50%-70% of their 1-RM.

Can isometric resistance training safely reduce high blood pressure?

Some studies suggest isometric resistance training can help reduce resting blood pressure. However, it should be performed under professional supervision due to the potential for acute increases in blood pressure during the exercise.

What is hypertension training?

Hypertension training refers to an exercise program designed for individuals with high blood pressure. This typically includes a combination of moderate-intensity aerobic and resistance exercises, alongside lifestyle modifications such as healthy eating and stress management.

Training Clients With Hypertension: The Bottom Line

Training clients with hypertension requires a lot more than just general knowledge. It requires education, empathy, and a host of software tools built with customization and adaptation in mind.

Lani Hudgins
Excellent choice for my business! I tried nearly all the “major” platforms and found Exercise.com to be the most intuitive.
Lani Hudgins
Certified Personal Trainer & Nutrition Coach

To learn more about how Exercise.com can help you train hypertensive clients, book a demo today!


  1. https://www.acsm.org/blog-detail/acsm-certified-blog/2019/02/27/exercise-hypertension-prevention-treatment
Thomas Barnett is a writer for Exercise.com and a Professor of Exercise Science at Keiser University. He has over eight years of experience working in rehabilitation, personal training, and strength and conditioning. Additionally, Thomas holds a Master's Degree in Human Performance, a Bachelor's Degree in Exercise Science, is an NSCA Certified Strength and Conditioning Specialist (CSCS), a Certified USA Weightlifting Coach, and holds the ACSM Exercise is Medicine Credential. When he isn't working or training, he enjoys a good game of rugby or can be found fishing and/or exploring the Florida coast.
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