Essential pre-exercise procedures for patients with hypertension: physical examination and safety assessment

Before starting exercise, a physical examination is recommended: Before deciding to adopt exercise therapy, patients should first consult with a doctor about their physical condition. The doctor will first determine if the patient is suitable for exercise therapy, and then, much like prescribing medication, write an "exercise prescription" to guide the patient's exercise. The patient then begins exercise therapy according to the prescription.

Although exercise therapy is for therapeutic purposes, it is still a form of exercise. Whether someone appears healthy or has an illness, a thorough physical examination should be conducted beforehand to determine their suitability for exercise. This is because, in rare cases, there have been instances of death due to exercise.

Some people appear healthy in daily life, but they may sometimes have undetectable (silent) heart disease, which may manifest as symptoms during exercise. Therefore, exercise experts recommend a physical examination and exercise stress test before starting any exercise program. Exercise stress tests include stair climbing (masda method), walking on a conveyor belt (stationary bike stress test), and cycling (ergometer stress test), which involve drawing an electrocardiogram and measuring blood pressure.

The stair-climbing stress test requires considerable equipment. The patient walks up and down stairs for 3 minutes, the number of repetitions depending on age and weight. Electrocardiograms (ECGs) are recorded before and after the test. During the exercise stress test, if the ECG shows chest pain, shortness of breath, arrhythmia, or coronary heart disease, it is best to avoid exercise. Worsening heart disease during exercise would be counterproductive. Exercise therapy is not suitable for people with high blood pressure, as exercise raises blood pressure, potentially leading to a stroke. While exercise therapy can lower blood pressure, everything has two sides. Therefore, the decision to use exercise therapy should be made under the guidance of a doctor.