High Blood Pressure During Exercise

Does an exaggerated rise in blood pressure during exercise predict who will develop high blood pressure in the future?

For athletes, probably not. Many research articles have shown that people who develop very high blood pressure during exercise are the ones most likely to develop high blood pressure in later years (American Journal of Hypertension, April 2004). Textbooks explain that these people have arteries that do not expand as much as normal arteries when blood is pumped to them. When your heart beats, it squeezes blood from inside its chambers to the large arteries. This sudden bolus of blood causes normal arteries to expand just as balloons do when they fill with air. The walls of arteries have sensors that allow arteries to expand with each pulse of blood. If the arteries do not expand enough when blood enters them, blood pressure can rise very high. So exercise-induced systolic blood pressures greater than 190 in non-exercisers predict high blood pressure in the future. It's different for athletes who have the strongest hearts that push blood with the greatest force, so they have the highest rises in blood pressure during aerobic exercise (American Journal of Hypertension, November 1996). Blood pressure is determined by the force of the heart's contraction times the resistance in the blood vessels. Normal blood pressure is no higher than 120 when the heart contracts and 80 when it relaxes. During exercise, blood pressure increases markedly, with the highest blood pressures in experienced weight lifters occurring during a double-leg press where average values are 320/250 mm Hg, with pressures reported as high as 480/350 mm Hg (Journal of Applied Physiology, March 1985). It is normal for conditioned athletes to have blood pressures of 200/70 when they run on a treadmill.

The good news about exercise is that just 20 minutes of running on a treadmill or lifting weights lowers blood pressure for about seven hours of normal physical activity (Journal of Strength and Conditioning Research, November 2009).

Ninety percent of North Americans will develop high blood pressure, which increases risk for heart attacks, strokes, kidney damage and sudden death. If you have an exaggerated blood pressure rise during exercise and you are an athlete, you probably need only be concerned with your blood pressure at bedtime, but we have no good data on this. If it is above 120, you have high blood pressure and need to be treated.

However, if you are not a regular exerciser and your exercise-induced blood pressure is above 190, you should go on a heart attack prevention program that includes a diet that is high in plants and low in meat and refined carbohydrates, check with your doctor for clearance to start exercising regularly, lose weight if overweight, avoid smoke and stimulants or drugs that raise blood pressure. Diet to control high blood pressure