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Exercise is good for your overall health. It can improve mood, help maintain a healthy weight, and support cardiovascular function. But, if you’re diagnosed with high blood pressure, and require medication to manage it—is exercise off the table?
Two pharmacists help explain the safety of mixing the blood pressure medication lisinopril and exercise.
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What is lisinopril?
Lisinopril, also known by its brand names Prinivil and Zestril, is an angiotensin-converting enzyme inhibitor (ACE inhibitor). It works by relaxing your blood vessels, which lowers your blood pressure and reduces stress on your heart.
- Hypertension (high blood pressure)
- Congestive heart failure
- Myocardial infarction (heart attack)
It can also be used off-label for diabetic nephropathy (diabetic kidney disease).
What are some side effects of lisinopril?
Side effects from lisinopril may include:
- Headache
- Dry cough
- Dizziness
- Hypotension (low blood pressure)
Serious side effects of lisinopril may include:
- Hyperkalemia (high potassium)
- Angioedema (swelling in skin tissues)
- Renal insufficiency (poor kidney function)
- Hepatic failure (liver failure)
As long as your heart is healthy enough for a workout, lisinopril and exercise is a safe combo. It’s the blood pressure-lowering effects that have the biggest impact on exercise.
Can you exercise while taking lisinopril?
Generally, yes. It’s safe to work out while taking lisinopril “as long as your doctor says you are generally fit enough to exercise,” says Wendi Jones, Pharm.D., a hospital pharmacist in North Carolina and founder of Be Healthy Apothecary. Some research shows that ACE inhibitors do not impair physical performance, making them a good choice for those with an active lifestyle. Just be sure that your blood pressure doesn’t dip too low during or after your workout.
Lisinopril reduces blood pressure at rest and during exercise. And, one of the main reasons physicians recommend exercise as part of a healthy lifestyle is that it can decrease blood pressure, too. “Both ACE inhibitors [like lisinopril] and exercise help to relax blood vessels, so the combination of taking an ACE inhibitor while exercising may have a synergistic effect, meaning that the two together may lower blood pressure and increase adverse effects more than either one alone,” says Danielle Plummer, Pharm.D., creator of HG Pharmacist.
In other words, if you’re not careful you may experience side effects of hypotension, such as dizziness, lightheadedness, nausea, dehydration, and even fainting. These side effects can be even more hazardous if they occur when you’re running on a treadmill or lifting weights—which is why it’s important to pay attention to your body while taking lisinopril before incorporating exercise into your daily routine.
How to safely exercise while taking lisinopril
While exercise is a key ingredient to a healthy lifestyle, there are extra precautions to consider when taking a medication like lisinopril.
“Be very careful in the type of exercise chosen, the duration of exercise, and the time of day chosen to exercise,” Dr. Plummer says. “Use extreme caution when exercising after first starting the medication and after dose increases.” When first starting lisinopril you won’t know how the medication affects you, or what side effects you might experience, likewise if you increase the dosage.
Type of exercise
Not all exercises are created equal when you’re taking lisinopril, or another ACE inhibitor. A rigorous exercise routine might not be an ideal option when you first begin lisinopril, especially as you learn how the medication affects you. “When people first begin blood pressure lowering medications [ACE inhibitors], they can often feel lightheaded or dizzy,” Dr. Jones says.
Instead, try a lower intensity workout to start. While you’re adjusting to lisinopril, you might consider light exercise such as walking. “Be cautious in any exercise where you change position,” Dr. Plummer advises. “For example, if you stand up too fast after exercising or lying down, you could get orthostatic hypotension, which is feeling dizzy and getting a head rush, which puts you at risk of falling down.”
Duration of exercise
As you adjust to your medication it’s important to take it easy and be aware of how exercise is affecting your blood pressure. Because lisinopril lowers your blood pressure, and exercising can lower it even further, it’s best to keep the duration of your exercises short, so that you can evaluate how you’re feeling, says Dr. Plummer. Twenty minutes is probably a good starting point.
Time of day
Once you take lisinopril, it begins working within an hour, and has its greatest effect after about six hours. Lisinopril is a once-daily medication that should be taken at the same time every day. For the first week you take it, note how you’re feeling after an hour, six hours, and right before your next dose. Then, see if exercise changes that.
The effects of lisinopril lessen throughout the day, which means it’s best to exercise later in the day if you’re taking your medication first thing in the morning.
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What are some safe exercises to do while taking lisinopril?
When beginning to exercise after starting lisinopril, start with low-intensity exercises such as:
- Walking
- Swimming
- Hiking
- Stationary cycling
- Seated desk exercises
If you experience no dizziness or side effects that disrupt your exercise routine, then you should be free to return to your regular workouts.
Talk to your healthcare provider about lisinopril and exercise tolerance
It’s important to make sure that you receive the go ahead from your healthcare provider to exercise if you’re taking lisinopril.
“Working with your medical team is the safest way to create a safe plan for exercising,” Dr. Plummer says. Your healthcare provider should be able to give you advice on the best exercises to start with while evaluating your physical health and telling you things to watch out for.
