“Cardiovascular health is defined by your capacity to exert yourself,” says Nicole Belkin, MD, an orthopedic surgeon at NewYork-Presbyterian/ Columbia University Medical Center. “Regular physical activity trains the cardiovascular system to expand the level of demand and increase its capacity. This results in increased blood flow and blood volume to the heart.”
Picture yourself working out. Are you lifting heavy weights? Stretching your muscles? Or maybe you're performing an activity that causes you to sweat and breathe hard that makes your blood pump through your veins as it carries oxygen to your muscles to keep you going. If you're performing this last activity, then you're engaging in aerobic exercise.
The question of BP lowering with aerobic exercise in type 2 diabetics has been studied. In the Early Activity in Type 2 Diabetes (ACTID) trial, 593 newly diagnosed diabetics were randomized to use of a pedometer in a program that included intense counseling or standard or intense dietary advice.46 There was no difference in SBP or DBP after 6 or 12 months, even though the participants using pedometers increased their steps by 17% on average. Whether the exercise was merely of too low a “dose” to be effective is unclear. There may be some male-female differences in BP response to aerobic exercise, with women exhibiting BP lowering with resistance compared with aerobic exercise and men responding similarly to both types of exercise.47 The 2013 AHA Scientific Statement recommends at least 30 minutes of moderate intensity aerobic exercise per day most days of the week.2 The authors assigned dynamic aerobic exercise a Class I, level of evidence A recommendation in those for whom it is not contraindicated. Our review of the evidence since 2013, as well as that from another group, confirm these recommendations.41,48 Whether or not high versus moderate (or interval) intensity training is optimal for BP-lowering as well as other aspects of the dose-response effect (i.e., ideal duration of cumulative exercise per week) and the potential impact of different types of aerobic activity requires further investigation.
Add strengthening exercises to your walking workout to build muscle. Even though strength training does not burn considerable calories, it replaces your fat with lean muscle mass. Your body works harder to sustain your muscle mass, raising your resting metabolism so you burn more calories throughout the day. Invest in light hand weights or wrist weights and pump your hands as you walk. Build lower body muscles by lifting your knees high during part of your walk. Stop every five minutes and do a series of squats or lunges.
Whether you’re rowing on water or indoors, it’s important to use the correct technique to avoid injury, especially to the lower back. Other common injuries include knee pain, tendonitis in the wrist and blisters on your hands. If you join a club, you should get advice on technique from the coach; if you use a rowing machine at the gym, ask a qualified instructor. If you row outdoors, you also need to be able to swim and wear a life jacket, know how to row safely — and remember to use sunscreen!