Have High Blood Pressure? Cardiologists Share 6 Key Things to Know Before Starting Cardio

• Regular aerobic exercise can help lower blood pressure over time.
• Choose an exercise that is safe for you, start slowly, and work toward 150 minutes of moderate activity each week.
• Talk to your doctor before exercising if you have heart disease, symptoms, or high blood pressure.

If you live with high blood pressure, your doctor may already have encouraged you to become more active, and for good reason. “Exercise is probably the most effective lifestyle intervention for lowering blood pressure,” says Fred Watson, M.D., FACC. Studies suggest regular aerobic activity can reduce systolic blood pressure, which may lower the risk of heart disease and stroke over time. “Aerobic exercise helps blood vessels relax and function more efficiently,” says Adedapo Iluyomade, M.D., M.B.A., FACC.

Walking and running are both accessible ways to get more aerobic exercise. Before you begin, though, it helps to know how much activity to target, how to start safely, and when it’s time to speak with your doctor. Here’s what to keep in mind.

1. Some People Should Get Medical Clearance First

Before you start, it’s important to know whether you need approval from a doctor. “Get cleared first if you have known heart disease, concerning chest symptoms or are very deconditioned,” says Tisa Saha, M.D., FACC. Beginning an exercise program when elevated blood pressure is already stressing the heart and arteries can carry real risks. Going too hard, too soon, without knowing your baseline may trigger a cardiac event in people with underlying conditions.

You should also check with your doctor if your blood pressure is very high or not well controlled. A clinician can help you choose a safe starting point and may suggest adjustments if you also have issues such as diabetes or joint problems.

2. Walking Counts

Intensity is not everything. “Don’t underestimate walking, simply because it feels less intense than running. For blood pressure control, the best exercise is usually the one you can safely and consistently do week after week,” Iluyomade says.

Running can be a good option if your body tolerates it and you enjoy it. But brisk walking also qualifies as moderate aerobic activity. For many people, it is gentler on the joints and easier to work into daily life.

3. Start Slow and Build Gradually

In the beginning, the goal is steady progress rather than performance. “Start slow and increase speed and distance gradually. Aim for a moderate level of effort; you should be able to complete a sentence or hold a conversation while you walk. Begin with 10 minutes a day and add a few minutes each week,” Watson says. This talk test is a useful guide. If speaking in full sentences feels difficult, slow down.

4. Aim for 150 Minutes a Week Plus Strength Training

“Aim for 150 minutes per week of moderate aerobic activity/zone 2 cardio (e.g., brisk walking) and also muscle-strengthening work/resistance training on two or more days for optimal results,” Watson says.

That works out to about 30 minutes a day, five days a week, though you can also split it into shorter sessions. When you add strength training, keep your breathing steady throughout each movement.

5. Exercise Works Alongside Medication

If your doctor has prescribed medication, keep taking it. “Exercise complements, rather than replaces, medication when medication is needed,” Iluyomade says.

Continue taking your medication as directed unless your doctor tells you otherwise. Some medications can also affect how your body responds to exercise. Beta blockers, for example, can keep your heart rate lower than usual, which makes heart-rate targets less dependable. In that case, the talk test may be a better way to gauge effort.

6. Know When to Stop

Pay close attention to how you feel during every workout. Stop and get medical help if you develop chest pain or pressure, dizziness, fainting, unusual shortness of breath, or an irregular heartbeat. Warming up for five to 10 minutes and cooling down afterward can also help, giving your heart rate and blood pressure time to rise and fall gradually.

Tips for Sticking to Your Routine

• Schedule your workouts. Put walks on your calendar like any other appointment. A set time, such as after breakfast or during your lunch break, makes the habit easier to keep.
• Track your progress. Log your minutes, distance, or steps in an app or notebook. If your doctor recommends it, you can also check your blood pressure at home and share the readings at your next visit.
• Find a walking partner. A friend, family member, or walking group can make workouts more enjoyable. Having someone counting on you also makes it harder to skip.
• Change up your route. Try a new park, trail, or neighborhood when your usual path starts to feel boring. Variety can help keep you motivated.
• Set small, realistic goals. Focus on adding a few minutes each week instead of making big jumps. Small wins add up and help build confidence.
• Plan for bad weather. Have a backup, such as a treadmill, indoor track, or mall. That way, rain or heat does not derail your week.

Our Expert Take

Walking and running can be powerful tools for managing high blood pressure, but they work best as part of a long-term routine. Start with short, moderate sessions and build gradually. Aim for 150 minutes of aerobic activity a week and add strength training on at least two days. If you have heart disease, troubling symptoms, or very high blood pressure, talk with your doctor before getting started. Keep taking any medications you have been prescribed, and remember that exercise works best alongside a broader care plan. You do not need to run fast or far to make progress; the routine that helps most is the one you can maintain week after week.