If you are like many older Americans with high blood pressure, you probably lead a fairly sedentary lifestyle. But studies show that beginning a physical activity program at any age can improve your heart health. And the good news is that the studies also show that the level of physical activity does not have to be strenuous to reap the benefits.

Some of the heart benefits of physical activity are related to lowering of blood pressure. What's more, getting moving will also help reduce cholesterol, blood sugar, and body weight and lower the likelihood of such hypertension complications as heart attacks and strokes.

Physical Activity and Blood Pressure -- How does physical activity lower blood pressure? Part of the explanation is that exercise produces weight loss and increased sensitivity to insulin (a hormone involved in the control of blood sugar), which in turn decrease blood pressure. But more directly, physical activity makes the heart stronger, and a stronger heart can pump more blood with less effort. This means less pressure on the walls of the arteries as blood flows from the heart to your tissues.

Physical activity also appears to improve endothelial function, the ability of blood vessels to dilate in response to increased blood flow, and may decrease the activity of the sympathetic nervous system, which causes blood pressure to rise when you are under stress.

Getting Started -- The key to getting started is to find a physical activity that is safe for your specific health situation and enjoyable enough to do on a regular basis. For most people, that's a simple walking routine.

• Step 1: Talk to your doctor. The first step is to check in with your doctor. This is particularly important if you have any chronic health problems like heart disease, diabetes, high blood pressure, or arthritis; are over age 50; or haven't exercised in a long time.
• Step 2: Start slowly. If that means you walk for only 10 minutes every other day for the first week, that's fine. But over the next weeks and months, slowly increase the frequency and duration of your walks. Ideally, you want to build up to exercising five to seven days a week, for 30-60 minutes at a time. But studies show that less frequent activity (such as three times a week) and shorter bouts of activity (for example, three 10-minute sessions a day) can be beneficial as well, so don't give up on exercise just because you are unable to do the ideal amount. Every little bit does count.
• Step 3: Keep it moderate. Walking and other aerobic activities should be at moderate intensity. You should be able to carry on a conversation while exercising. If you are gasping for breath, it's not moderate. The actual definition of moderate intensity is based on heart rate.
  Maximum heart rate is 220 minus your age. For most people, moderate is 50–70% of that number. For example, if you are age 60, your maximum heart rate is 220 – 60 = 160. Then multiply 160 x 0.50 = 80 and 160 x 0.70 = 112. A moderate heart rate for you is between 80 and 112 beats per minute. However, if you've not been physically active in a while, moderate might be starting at 30–40% of maximal heart effort and building up slowly over a month or more.
  You can check your heart rate by finding the pulse in your neck or wrist, counting the number of beats in 10 seconds, and then multiplying that number by six. Alternatively, you can purchase a sensor to monitor heart rate.
• Step 4: Add some strength and balance exercises. Once you're comfortable with a walking routine, you can start some light weight training and balance exercises two to three times per week. For sample strength and balance exercises, see the National Institute on Aging's exercise guide at www.niapublications.org/exercisebook/ ExerciseGuideComplete.pdf. You can also obtain a free copy by calling 800-222-2225.