How exercise affects your blood pressure

The last time you went for a checkup, you were told your blood pressure was elevated and that exercise could help bring it down. But can a sweat sesh on a treadmill or in a spin class—where your heart is beating like crazy—really help lower your blood pressure? Doesn’t all that huffing and puffing indicate your heart is working hard and your blood pressure is actually going up rather than down?

It sounds counterintuitive, but your doctor is right: Exercise may lower your blood pressure if it’s high. Because it improves circulation, it may also help raise blood pressure if yours is too low.

“Overall, exercise is generally safe for someone with high or low blood pressure,” says Jason McKnight, MD, clinical assistant professor in the Department of Primary Care and Population Health at Texas A&M College of Medicine in College Station, Texas. “However, if you have either of these conditions, it’s best to speak with your healthcare provider before starting an exercise regimen. For someone with highly elevated and uncontrolled blood pressure, an exercise-related increase in blood pressure could be dangerous. For someone with low blood pressure, the risks and benefits of exercise would depend on the cause of the low blood pressure.”

What is blood pressure?

Blood pressure is a measure of two things. It’s the pressure, or force, inside your artery walls as blood is pumped out from the heart to the rest of the body. It’s also the pressure in the arteries when the heart is at rest between beats. That’s why when your blood pressure is measured, you’ll hear two numbers given. For example, you might hear that your blood pressure reading is 110/70 mmHg (mmHg is millimeters of mercury, which represents how high the mercury in the blood pressure cuff is raised when your blood pressure is taken). This is considered normal blood pressure. Or, you might hear that your blood pressure is 140/90 mmHg, which is considered high. The top number is called the systolic blood pressure and the bottom number is the diastolic pressure.

Low blood pressure (called hypotension) isn’t considered a significant health problem unless it’s causing symptoms such as dizziness, nausea, or fainting. High blood pressure, called hypertension, however, can be a serious condition. Left untreated, it can cause damage to arteries that can lead to heart disease, heart failure, and stroke. Nearly half of all adults in this country have high blood pressure, reports the Centers for Disease Control and Prevention (CDC).

How does exercise affect blood pressure?

Like every other muscle in your body, your heart gets stronger when you exercise it. And that, in turn, makes it more efficient at pumping blood.

“Blood vessels dilate and become less stiff as your heart beats faster and harder,” explains  Anuj R. Shah, MD, a cardiologist and director of Apex Heart and Vascular Care in Passaic, New Jersey. “The vessels stretch and accommodate the excess pressure to keep blood pressure in control. So exercise has a counterbalancing impact. During exercise, the heart pumps harder and blood pressure raises modestly, but the blood vessels become more elastic, which can help—and even prevent—hypertension.”

What’s more, an exercise program can help improve other health factors, such as obesity and high cholesterol, which are risk factors for high blood pressure. When you carry a lot of extra weight, for example, your heart has to pump extra hard to get blood flow around the body, and that raises pressure inside the artery walls. According to the American Society for Metabolic and Bariatric Surgery, roughly three out of four cases of hypertension are related to obesity. 

Still, it’s important to note that not everyone with hypertension who works out experiences the blood pressure lowering effects of exercise. In one study published in the journal Plos One, roughly 25% of people did not see their blood pressure lowered with exercise.

What should my blood pressure be after exercise?

To understand what your blood pressure responses should be after physical activity, you should know what your blood pressure is under normal circumstances. 

Blood pressure goes up during and immediately after exercise, as your heart works hard to get blood pumped to muscles. Usually, you’ll only see a rise in the systolic (upper) number, while the diastolic (bottom) number stays relatively the same or decreases slightly. How high blood pressure increases and how long it stays there is individual, but on average, it should return to normal in just a few minutes.

If you want to measure your blood pressure changes after exercise, you can purchase a blood pressure cuff to use at home. Dr. Shah recommends waiting until your heart rate returns to normal. Your normal heart rate, or pulse, is the number of times the heart beats per minute at rest. Find your pulse (either on your wrist or neck) and count the number of beats for 60 seconds when you first wake up. This is your baseline heart rate. “The same factors that are driving your heart rate up are also raising your blood pressure,” notes Dr. Shah. “I recommend waiting about five minutes after exercise and then checking your blood pressure.”

So, how much can exercise actually lower your blood pressure—and for how long? A lot depends on the type of exercise you do (cardiovascular exercise versus using free weights, for example), how long you do it, your exercise intensity, your overall physical condition, and your normal blood pressure at rest. 

The American College of Sports Medicine (ACSM) reports that aerobic exercise—exercise that gets your heart rate up, such as brisk walking, swimming, or biking—can lower blood pressure by 5 to 7 mmHg in those with hypertension. That lower blood pressure occurs shortly after exercise and can last a full 24 hours afterward. This is called post-exercise hypotension. 

There’s good evidence to suggest that other forms of exercise, such as resistance training (e.g., lifting hand weights), can also lower blood pressure. One study found that this kind of exercise lowered blood pressure by nearly 4 mmHg. But post-exercise reductions in blood pressure are usually temporary unless you consistently exercise. That’s why experts, such as those at the ACSM, recommend you exercise most days of the week if you have hypertension. 

Low blood pressure after exercise

Exercise can lower blood pressure in people with normal or elevated blood pressure levels. But it’s possible that a workout can lower blood pressure too much, especially if you’re already predisposed to low blood pressure due to things like:

• Taking certain medications. Some antidepressants, anti-anxiety medications, diuretics (medications that increase urine output), drugs for heart disease, and painkillers can lower blood pressure. In some cases, blood pressure medications themselves can lower pressure too much.
• Having endocrine conditions like diabetes or parathyroid disease
• Having heart problems like heart valve disease or heart failure
• Being dehydrated, which has an effect on circulation

How do you know if you have low blood pressure? The American Heart Association (AHA) notes these symptoms:

• Dizziness or lightheadedness
• Fainting
• Nausea
• Problems with concentration
• Fast, shallow breathing
• Blurry vision
• Skin that looks pale and feels cold
• Being unusually tired

If you’re experiencing any of these symptoms, see your healthcare provider. Low blood pressure can sometimes signal something serious, like internal blood loss, and the dizziness that often accompanies it can lead to falls and other accidents. Your healthcare provider may advise tweaking any medications you’re on or lowering exercise intensity, depending on the cause of the low blood pressure.

High blood pressure after exercise

Blood pressure levels usually rise during exercise. “It is normal for blood pressure to be higher than baseline both during and immediately after exercise,” says Dr. McKnight. In people with normal or high blood pressure, exercise can cause an increase of 50 to 70 mmHg in systolic blood pressure. Get immediate medical attention if your blood pressure exceeds 180/120 and you’re experiencing symptoms such as:

• Severe chest pain
• Shortness of breath
• Back pain
• Vision problems
• Severe headache
• Nausea or vomiting
• Seizures

Hypertensive crisis is considered a medical emergency and could lead to stroke or organ damage if left untreated.

Blood pressure and exercise: 6 safety tips

First things first: Get medical advice before beginning any exercise program. Your healthcare provider can give you guidelines and tell you what to watch out for. It’s also possible that your medications may need to be adjusted. 

“Blood pressure medications can interfere with certain aspects of your exercise regimen,” says Dr. McKnight. “Some medications may prevent your heart rate from increasing to your goal heart rate for your exercise. Other medications may lead to an increased risk of dehydration if you are participating in high-intensity workouts and not drinking adequate fluids.”

Once you have the medical clearance, make exercising safer (and more effective at regulating blood pressure) with these tips:

1. Aim for 150 minutes of moderate-intensity exercise a week. You don’t need to do this in one single bout—you can break it up any way you want over the course of a week. Even doing three 10-minute exercise sessions per day can benefit your heart health. To determine what’s moderate intensity, do a little math. Subtract your age from 220—that’s your maximum heart rate. You want to be exercising at 50% to 85% of your maximum heart rate, says the AHA. Math not your thing? If you can only speak in short, clipped sentences when you work out, you’re probably in your target zone. Or, try using a wearable heart rate tracker.
2. Warm up and cool down. They are important parts of your workout that can help gradually increase and decrease your heart rate. Try walking, cycling, or jumping rope— at a slow pace for 5 to 10 minutes—before and after your workout. 
3. Pace yourself. Gradually build up from 50% of your target heart rate to 85%. 
4. Mix things up. For example, walk one day, work on toning using your own body weight as resistance, the next. This will keep things interesting and ensure you’re getting a total body workout.
5. Be careful with weight lifting. While strength training is safe for people with high blood pressure, pushing yourself with weights that test your limits and/or doing multiple sets with little rest in between, can raise blood pressure too high. For most people, however, the short-term risk of blood pressure spikes is balanced by the long-term benefits of weight lifting. 
6. Avoid exercise that quickly has you changing body positions. For example, be careful when moving from a sitting to a standing position too quickly—especially if you have low blood pressure. Other exercises to be mindful of include some yoga poses and exercises like burpees or sit ups. Changing positions rapidly can make some people with low blood pressure feel lightheaded or dizzy.

Adding exercise into your daily routine provides many benefits for your physical and mental wellbeing. In addition to controlling blood pressure, exercise has several perks like stress reduction, increased energy, and more.