Managing my hypertension has required some trial and error
One challenge I face is finding the discipline to exercise enough each day
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Since writing my last column in December, I’ve been working to find the most effective exercise routine and remedies to prevent my blood pressure (BP) from rising too high. Uncontrolled hypertension can lead to heart attack, stroke, and other serious health issues.
Until recently, like many people with Fabry disease (FD), I tended to have significantly lower blood pressure than the general population, even though FD can also be associated with a high prevalence of heart, kidney, and nervous system diseases linked to hypertension.
However, while many with FD have lower BP, a study shows that about 50% — 54% of men and 47% of women with FD — have clinic BP values above 130/80 mmHg, which can be dangerous.
Experimenting with my exercise regimen
I’m unsure whether my recently elevated blood pressure is due to my 2020 heart transplant, aging (I’m 71), or other factors. I read that, in addition to disease-specific therapy, controlling BP is crucial in FD to slow disease progression and improve outcomes.
The American Heart Association offers helpful online resources, including guides on understanding blood pressure with easy-to-read tables on BP stages, and information about the health risks associated with high blood pressure.
My goal is to maintain normal BP (under 120/80 mmHg), but this is challenging. I’ve learned that the maximum recommended dose of telmisartan, an angiotensin II receptor blocker, alone isn’t enough to control my BP.
Along with general BP management guidelines for my sporadic hypertension, I’ve had to adapt my exercise routine to maximize the benefits of physical activity with a transplanted, denervated heart (meaning the nerves supplying the heart were surgically removed).
I’ve been experimenting to find the right duration and intensity of exercise to keep my BP in check. My routine includes walking on a treadmill or outdoors, physical therapy, tai chi, yoga, pushups, chin-ups, and other strength exercises almost daily. Outside of my prescribed therapy for back and spine issues, I frequently follow exercise routines from online sources, as there are many free or affordable fitness options available.
As I work to understand my exercise needs and limitations, I record my BP readings first thing in the morning, after exercising, and after walking on the treadmill. My BP often rises to 130/90 mmHg or slightly higher when the effect of exercise wears off, usually within a day or so.
Before my heart transplant, my heart rate was about 40 beats per minute; with an implanted pacemaker/defibrillator, it increased to 60 bpm. After transplantation, the average resting heart rate is initially 90–110 bpm, ideally settling below 90 bpm over time. The medical literature suggests that keeping my heart rate in the 80s may prolong the lifespan of the transplanted heart. My current resting heart rate is usually around 85 bpm, which is promising.
If I walk on the treadmill for at least 30 minutes at a pace that raises my heart rate to 120–140 bpm, or complete a similarly intense routine, my BP usually returns to normal. Sometimes I need both walking and other forms of exercise to reach this goal. Because my heart was denervated during transplant, my nervous system doesn’t send the same signals, so it takes more than an hour for my heart rate to return to resting levels after exercise.
One challenge I face in keeping my blood pressure normal is finding the time and discipline to walk or do enough other exercises daily. Many factors can disrupt my routine. I’ll continue working with my doctor to explore medication options that might reduce my reliance on strict physical activity, while avoiding unwanted side effects. To support my health, I also focus on healthy eating, managing cholesterol, staying hydrated, and getting enough sleep.
Although my situation is complicated by my transplanted heart, I hope others with heart transplants or high blood pressure find my experience insightful.
Note: Fabry Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Fabry Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Fabry disease.
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