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High Blood Pressure in Endurance Athletes

author image Andrea Cespedes
Andrea Cespedes is a professionally trained chef who has focused studies in nutrition. With more than 20 years of experience in the fitness industry, she coaches cycling and running and teaches Pilates and yoga. She is an American Council on Exercise-certified personal trainer, RYT-200 and has degrees from Princeton and Columbia University.
High Blood Pressure in Endurance Athletes
Distance runners have a lower risk of high blood pressure. Photo Credit lzf/iStock/Getty Images

High blood pressure risk in athletes and physically active people is significantly lower than it is in the rest of the population. Normal blood pressure in any person, active or not, is 120 mmHg over 80 mmHg. As blood flows, it applies force to the walls of the arteries. When this force is too high, a doctor diagnoses you with high blood pressure.

Although their risk is lower, endurance athletes aren't immune to having blood pressure that exceeds 120/80. Regular medical checkups that include blood pressure measurements can help you stay on top of your blood pressure levels and health.

Implications of High Blood Pressure

High blood pressure is a serious condition and should be managed with the advice of your health care professional. Untreated high blood pressure can damage your heart and increase your risk of heart disease. You're also more vulnerable to stroke, kidney damage, memory loss and peripheral artery disease, among other complications.

Blood pressure changes as your activity changes; it may be lower when you sleep or higher when you are active, for example. One high reading may be a fluke or a result of agitation of being in the doctor's office. But, if your readings are consistently high; you'll be diagnosed -- athlete or not. It can be dangerous to exercise with untreated high blood pressure because your blood pressure rises when you exert yourself.

Hypertension Risk

Hypertension is often associated with diets high in sodium, smoking, aging, stress, alcohol abuse, being overweight and inactivity. Many of these risky behaviors are an anathema to an endurance athlete. Even if you eat whole, unprocessed foods, manage your weight, exercise excessively and avoid abusing substances, you can't control your heredity and age. If you are an endurance athlete with high blood pressure and aren't eating your best or are overtly using alcohol and tobacco, halting these habits might help improve your performance and help your blood pressure normalize.

Certain supplements may can also affect your blood pressure, particularly stimulants in many energy products such as guanara, ma huang and ephedra. If you routinely rely on these energy sources to propel you through a long workout, let your doctor know.

Treatment Considerations

Make sure your doctor is aware that you are an endurance athlete when he offers treatment. In many cases, a lifestyle change is what you need to reduce blood pressure. Changing your diet, reducing stress or losing weight have no negative side effects, but are possible first steps toward normalizing blood pressure levels.

Some high blood pressure medications can make exercise seem harder. If you need medication, work with your doctor to figure out which one works best for you.

Exercise Recommendations

Always talk to your doctor about how high blood pressure and your treatment affect your exercise regimen. The Journal of the American College of Cardiology published the proceedings of the 36th Bethesda Conference on Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities in 2005 as general guidelines; these guidelines continue to stand. Athletes who have high normal blood pressure or low levels of hypertension usually have no restrictions on exercise, but they should get their blood pressure checked every two to four months. For endurance athletes with moderate or severe hypertension, blood pressure levels should be controlled before participating in endurance activity.

Competition Considerations

Endurance activity does not cause chronic high blood pressure. In fact, high blood pressure measurements are usually lowered with regular endurance exercise according to a report in the 2013 issue of the Journal of the American Heart Association. Although some concerns about heart damage from excessive endurance work, like repeat ultra-races of 50 miles or more, have arisen as reported by the Cleveland Clinic in 2014, these are usually isolated to actual heart damage and rhythm disorders and aren't clearly linked to the exercise itself.

Some medications for hypertension are banned by the World Anti-Doping Agency, the U.S. Olympic Committee and the NCAA. If you compete in an endurance event sanctioned or tested by one of these organizations, you risk disqualification if you're using a banned drug.

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