Exercise-Induced Hypertension
Do runners and people lifting weights or doing isometric exercises experience a temporary rise in blood pressure?
Yes. In fact, it’s normal for blood pressure to rise somewhat during exercise due to increased cardiovascular demand and oxygen uptake from working muscles.
But what if blood pressure increases too much?
Exercise-Induced Hypertension in Healthy People
In healthy individuals exercise-induced hypertension is defined as elevated blood pressure above 190 systolic for females and 210 systolic for males during exercise. It is relatively common.
Maximum static exercises such as bench pressing heavy weights can temporarily spike blood pressure over 320/250.
Exercise Induced Hypertension and Aortic Disease
In people with aortic aneurysms or post aortic dissection, the exercise induced hypertension blood pressure threshold is lower because the aorta is diseased.
For example, with aerobic exercise such as running, Dr. Siddharth Prakash of the University of Texas recommends an upper end blood pressure reading of not more than 165/90 for people with aortic disease.
The maximum safe blood pressure level for isometric exercises or weight lifting is not yet known.
But keeping blood pressure under a safe threshold for those activities includes factors such as the amount of the weight, no breath holding (valsalva), the number of and time between repetitions, the mass of a person’s muscles, age and sex.
Diagnosis
Exercise-induced hypertension can be diagnosed through an exercise stress test also called a treadmill test, which includes taking blood pressure during physical exertion.
(Personal note: I had an echocardiogram and EKG stress test at Northwestern Hospital in Chicago in 2023 before I ran the New York Marathon two years post dissection. That treadmill got my blood pressure up to 153 systolic towards the end of the stress test. During the Marathon, my BP was below 100 systolic in blood pressure readings at miles 9 and 26).
Treatment
In people with aortic disease, a main treatment to avoid exercise hypertension is by taking a beta blocker, which has the effect of reducing heart rate during exertion.
In fact, beta blockers have been shown to
significantly reduce exercise blood pressure by up to 25 percent.
Conclusion
Remember to discuss your exercise goals and limits with your cardiovascular physician on every visit.
For a deep dive, here are the sources relied on here.
Exercise-Induced Hypertension in Healthy Individuals and Athletes: Is it an Alarming Sign?
https://pmc.ncbi.nlm.nih.gov/articles/PMC7793423
Is Exercise Blood Pressure Putting the Brake on Exercise Rehabilitation after Acute Type A Aortic Dissection:
https://www.mdpi.com/2077-0383/11/10/2931…
Aerobic exercise reduces resting systolic and diastolic blood pressure in adults and reductions are greater in hypertensives than in normotensives.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2094526
Exercise hypertension diagnosed through an exercise stress test
https://pmc.ncbi.nlm.nih.gov/articles/PMC4315351
What to expect during a stress test