Slow and steady progression is best

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(Far left) Madam Teo Soon Hwa, 66, getting her blood pressure checked by senior physiotherapist Nadiah Mohamed Rahim before her physiotherapy session at National Heart Centre Singapore. Madam Teo, who wears a heart-rate monitor (left) during physiotherapy, doing bicep curls (above) under the supervision of Ms Nadiah.

(ST PHOTOS: GAVIN FOO)

Resistance training or strength training, which is using free weights or machines to do moves such as squats and chest presses; a combination of cardio and weights; and isometric exercise, which includes wall squats or leg extensions held for a prolonged period of time, can also lead to blood pressure reduction.

Some studies have found that isometric exercises were most effective in reducing systolic and diastolic blood pressure.

However, resistance training can cause higher spikes in blood pressure than aerobic exercise, which can be more dangerous for beginners.

Assistant professor Yeo Tee Joo, a senior consultant at National University Heart Centre, Singapore's department of cardiology, says this is because people tend to hold their breath - the Valsalva manoeuvre - and brace their core while lifting weights. This substantially increases the pressure within the chest and abdominal cavities.

Even isometric exercises, which require sustained muscular contraction and prolonged holding of positions, will increase blood pressure during the period of exercise.

"For those with hypertension, especially if not well controlled, it is safer to avoid instances in which the blood pressure can spike to extremely high levels," he says. "In such situations, starting with lowto moderate-intensity aerobic exercise, low-volume resistance training and short durations of isometric stretching is advisable."