10 BLOOD PRESSURE employees who had been formerly sedentary. After three months, participants showed improved oxygen consumption and reductions in diastolic blood pressure, total cholesterol, and LDL (“bad”) cholesterol. Individualized Exercise Plan The old adage is true: the best exercise is the one you can stick with. If the gym is not your style, lace up a good pair of walking shoes and walk a half an hour every day. If you’ve got achy joints, swimming or water aerobics may be more your speed. If you’re a social animal, you might be motivated by working out with a friend. Whatever gets you moving is the right activity for you. However, a combination of aerobic exercise, mild-to-moderate strength training, and stretching yields the best results. •  Aerobic exercise speeds up your heart rate and breathing rate. It includes activities such as stair-climbing, jogging, rowing, brisk walking, swimming, biking, and dancing. The Harvard Medical School Family Health Guide recommends getting aerobic exercise at least 30 minutes a day, five days a week. Aerobic exercise reduces blood pressure by widening the blood vessels, thereby enhancing blood flow. •  A meta-analysis from Tulane University looked at the impact of aerobic exercise on blood pressure. In most of the studies covered in this report, participants in the control groups were told not to change their usual lifestyle, including exercise.The authors associated aerobic activity with a significant drop in both systolic and diastolic blood pressure. •  Strength training increases strength, lean muscle, bone density, and insulin sensitivity. In a University of Maryland study, 21 previously sedentary older men and women with borderline hypertension embarked on a whole-body strength-training program. After six months, researchers discovered lower blood pressure in both men and women. Other Lifestyle Factors Diet, judicious use of supplements, and exercise are all important ways to help control blood pressure. But other factors affect blood pressure, too: smoking, alcohol intake, sleep, and social and emotional well-being. Cigarettes Although cigarette smoking raises blood pressure temporarily, it does not appear to directly cause long-term hypertension. However, smoking does increase the risk of heart attack and stroke in people who already have high blood pressure. Researchers analyzed information on 563,144 people in the Asia Cohort Studies Collaboration. Smokers with the highest blood pressure were more than nine times more likely to experience a stroke than smokers with the lowest blood pressure.The lead author of the study, Koshi Nakamura, MD, PhD, said that smoking and hypertension have a synergistic effect, worsening the damage that each risk factor causes on its own.