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Image Credit: zoff-photo/iStock/GettyImages Blood pressure is typically measured when the body is at rest, so it can be surprising to learn how much this common vital sign changes with physical activity. In fact, exercise causes an immediate increase in blood pressure -- particularly in the systolic, or top blood pressure number. How much your blood pressure changes during exercise correlates with your fitness level and health status, as well as the type and intensity of exercise, and these changes may provide important clues to your health. About Blood PressureBlood pressure measurements consist of two numbers. The first figure, the systolic, represents the pressure when your heart is contracting, and the second, or diastolic number, is a measure of the pressure in between beats -- when the heart is relaxed. Ideal resting blood pressure levels are below 120 systolic, and below 80 diastolic, or less than 120/80 mm Hg. According to the American Heart Association, the earliest stage of hypertension, or high blood pressure, is diagnosed when readings increase to 130/80 or above. Blood pressure is greatly influenced by cardiac output, or how much blood your heart pumps per minute, and peripheral resistance, which is the resistance of arteries to blood flow. These factors help to explain why blood pressure varies person to person, and why it changes with exercise. Blood Pressure During ExerciseHow much your blood pressure increases with exercise depends on your usual resting blood pressure levels, and your work rate, or the type, intensity and duration of physical activity. During exercise, your heart rate -- and systolic pressure -- go up, because cardiac output increases to pump more blood and oxygen to working muscles. In people without hypertension, most types of exercise can push systolic blood pressure to the 160 to 200 mm Hg range, and intense exercise such as weight lifting can temporarily push systolic pressure to even higher levels. Exercise also causes vasodilation, or the widening of blood vessels, which increases blood flow and decreases peripheral resistance -- which, in healthy people, keeps the diastolic blood pressure from rising during activity. Exaggerated Blood Pressure ResponseIn people with hypertension, a greater than expected increase in systolic and diastolic pressure can occur with exercise. Specifically, systolic pressure levels above 190 in women and above 210 in men are considered exercise hypertension and should be evaluated, as this exaggerated blood pressure response is commonly a result of artery stiffness and increased peripheral resistance -- and associated with a future risk of hypertension and heart disease. In people with coronary heart disease, abnormally low systolic and diastolic blood pressure may occur during exercise, and this also requires prompt evaluation. Anyone with hypertension or heart disease should seek and follow their doctor's advice in order to safely incorporate exercise into their lifestyle. Blood Pressure After ExerciseRight after exercise is stopped, blood pressure decreases -- often to levels a bit lower than normal resting blood pressure, and this effect can last for hours. Also, people who exercise regularly usually experience permanent improvements in resting blood pressure levels, as exercise strengthens the heart, helps with weight loss, improves circulation and lessens peripheral resistance -- all factors that benefit blood pressure. WarningsAn increase in blood pressure during exercise, particularly the systolic reading, is normal and expected, with levels that return to the usual resting range after recovery from exercise. However, some people experience abnormally low or high blood pressure during exercise, and this requires medical assessment. If you have hypertension that is not controlled, do not start an exercise program until your doctor approves that exercise is safe for you. If exercise causes severe shortness of breath, weakness, or dizziness, or causes any chest pain, even if this pain goes away when you stop, let your doctor know right away. Stop exercising and seek immediate medical attention or if you have chest pain, severe shortness of breath or pain in other areas, such as your arm, jaw or neck. Reviewed by Kay Peck, MPH RD Johns Hopkins Medicine
So-called "exercise hypertension," an abnormally high spike in blood pressure experienced by generally healthy people during a workout, is a known risk factor for permanent and serious high blood pressure at rest. But who gets it, and why, has been largely unknown. Now, Johns Hopkins scientists say they have reason to believe that the problem is rooted in the failure of cells that line the blood vessels to allow the arteries to expand to accommodate increased blood flow during exertion. "Our study shows that this impaired ability of the endothelial cells, which control large blood vessel relaxation, is a potential cause of exercise hypertension," says Kerry J. Stewart, Ed.D., lead study author and director of clinical exercise physiology at Hopkins. "Because as many as 90 percent of adults are at risk for developing high blood pressure, knowing this may point to a cellular target for preventive therapies." Normally during exercise, blood pressure increases to push the flow of oxygen-rich blood throughout the body. However, in some individuals, the response to exercise is exaggerated. Instead of reaching a systolic (upper number) blood pressure of around 200 mmHg at maximal exercise, they spike at 250 mmHg or higher. For the study, published in the April issue of the American Journal of Hypertension, the investigators evaluated 38 men and 44 women ages 55 to 75 who had untreated mild hypertension but were otherwise healthy. Their blood pressures at rest ranged from 130 to 159 mmHg systolic (the upper number) and 85 to 99 mmHg diastolic (the lower number). To measure endothelial function, the researchers first used ultrasound to measure the size of a large artery in the arm. Next they put a tight blood pressure cuff on one of the subjects' arms for five minutes to stop blood flow to the arm, then deflated the cuff, causing a surge of blood flow. They then repeated the artery size measurement, comparing it to the resting measure of the artery. The ability of the blood vessels to expand under these conditions is an indicator of endothelial function. In a second test, they examined blood vessel stiffness -- a marker of early heart disease -- by using ultrasound to measure how fast blood traveled from arteries in the subjects' necks to their legs with each heart beat. Because stiff blood vessels do not absorb any of the pressure behind the blood flow, the faster the blood travels, the more stiff the vessel is. They compared these readings with blood pressure measures taken at rest and while the participants walked to maximal effort on a treadmill. In their analysis, researchers found that higher blood pressures in response to exercise were associated with poorer blood vessel expansion in the arm following the cuff test, suggesting that the endothelial cells failed to dilate enough to handle the extra blood flow. There was no correlation between the stiffness of blood vessel walls or resting blood pressure with increased blood pressure during exercise. Impaired endothelial function is not solely related to high blood pressure, Stewart adds. It also is associated with aging, menopause, high cholesterol, smoking and diabetes, and may be a common process for developing heart disease among all of these risk factors. "It's too early to recommend that people have exercise tests just to measure their blood pressures," Stewart says. "However, careful attention should be paid to exercise blood pressure if measured as part of a medical evaluation, or during a workout at a gym, since it may be a warning that your resting blood pressure may also increase." The study was supported by the National Institutes of Health and the Johns Hopkins Bayview General Clinical Research Center. Study coauthors were Jidong Sung, Harry Silber, Jerome Fleg, Mark Kelemen, Katherine Turner, Anita Bacher, Devon Dobrosielski, James DeRegis, Edward Shapiro, and Pamela Ouyang. - -JHMI- - Stewart, Kerry et al., "Exaggerated Exercise Blood Pressure is Related to Impaired Endothelial Vasodilator Function," American Journal of Hypertension, April 2004;17(4):314-320. On the Web: American Journal of Hypertension What happens to systolic and diastolic blood pressure during exercise?In clinically healthy patients, systolic arterial blood pressure increases during dynamic exercise and stabilizes after 2-3 minutes of exercise of a given intensity [3, 4]. Diastolic blood pressure in such conditions usually remains unchanged or may decrease insignificantly [3].
Is systolic or diastolic more affected by exercise?Exercise increases systolic blood pressure. Systolic blood pressure is a measure of blood vessel pressure when your heart beats. Diastolic blood pressure is a measure of the pressure in the blood vessels between heartbeats. It shouldn't change significantly during exercise.
How is diastolic blood pressure in the body affected by exercise?Diastolic blood pressure is determined mainly by cardiac output and peripheral vascular resistance. During exercise, cardiac output increases and peripheral vascular resistance decreases in response to vasodilation of resistance vessels within exercising skeletal muscle.
Does diastolic pressure increase after exercise?Your diastolic pressure, between heartbeats, should not change significantly. Normal blood pressure is around 120/80 mmHg. It may rise to 140/90 after aerobic exercise such as running or swimming, though this is a ballpark figure as blood pressure varies a great deal from one person to another.
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Effect of exercise on systolic and diastolic blood pressure
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