How Does Exercise Affect Blood Pressure?

Exercise raises blood pressure while you are doing it, lowers it for hours afterwards, and with regular training lowers resting blood pressure by about as much as a single medication. Almost everyone with high blood pressure can benefit; only very high readings call for caution first.

During exercise: a normal rise

When you move, your muscles need more oxygen. The heart pumps harder and faster, so systolic pressure rises, often to 160–200 mmHg at peak effort in healthy people. Diastolic pressure stays about the same or falls slightly because blood vessels in the working muscles widen. This rise is normal and temporary.

Heavy weightlifting with breath-holding (straining against a closed throat) causes much larger, short spikes. That is why people with high blood pressure should breathe out during the effort and avoid maximal lifts.

After exercise: a lower reading

After a session of aerobic exercise, blood pressure usually drops below its starting level for several hours, sometimes up to a day. This is called post-exercise hypotension. It is one reason why regular, frequent activity works best: each session gives a short-term benefit, and the effects build up over weeks.

Regular training: lower resting blood pressure

Effects appear after a few weeks of training and fade within weeks if you stop. Isometric training performed well in recent analyses but is based on smaller studies. The best plan is the one you will keep doing.

How much and how often

• Aerobic: at least 150 minutes of moderate activity a week (for example 30 minutes on five days), or 75 minutes of vigorous activity. Moderate means you can talk but not sing.
• Dynamic resistance: two to three sessions a week, working the major muscle groups with moderate weights and 10–15 repetitions.
• Isometric: a typical program is three sessions a week of four two-minute holds (for example a wall sit or a handgrip squeeze at moderate effort), with one to two minutes of rest in between.
• Sit less: break up long periods of sitting with short walks.

Safety

• Very high blood pressure: if your resting blood pressure is 180/110 or higher, see a doctor and get it treated before starting vigorous exercise or heavy strength training. Gentle walking is usually fine. See hypertension stage 3 (grade 3).
• Heart disease or symptoms: if you have known heart disease, or get chest pain or unusual breathlessness on exertion, talk to your doctor before increasing activity.
• Start gradually, warm up and cool down for 5–10 minutes.
• Breathe steadily; do not hold your breath while lifting or holding a position.
• Medication: beta blockers limit how high your heart rate goes, so judge intensity by how hard it feels rather than by pulse. Diuretics make it more important to drink enough in the heat.
• Stop and seek help if you have chest pain, severe breathlessness, dizziness, palpitations or feel faint. If chest pain does not settle with rest, call 911 (US) or your local emergency number.

A note on measuring

Do not measure your blood pressure within 30 minutes after exercise; the reading will not reflect your usual resting value. See measuring blood pressure correctly.

A blood pressure that rises unusually high during a standard exercise test can be an early sign of future hypertension, so it is worth checking resting values regularly.

See also: 5 Quick and Easy Ways to Lower Your Blood Pressure, age and blood pressure and hypertension stage 1 (grade 1).