Blood pressure is a common vital sign which is typically measured when the body is at rest. A blood pressure reading consists 2 numbers. The top number, or systolic, is the pressure against the artery walls when the heart contracts, and the diastolic is the pressure in between heart beats. Although regular physical activity helps lower resting blood pressure, these numbers can change with movement and exercise.
Systolic Pressure Changes
During exercise, blood flow increases to provide more oxygen to the working muscles. This increased cardiac output is associated with a rise in heart rate and systolic blood pressure which both increase along with exercise intensity. In people with normal resting blood pressure, the systolic pressure could be expected to increase up to 200 mm Hg during exercise, which compares to a normal resting systolic pressure of less than 120 mm Hg.
Diastolic Pressure Changes
In people with normal blood pressure, diastolic pressure runs below 80 mm Hg. During exercise, the diastolic blood pressure stays about the same or falls slightly. This is because exercise dilates or expands blood vessels, improves blood flow and decreases the resistance to blood flow within the arteries. Blood pressure changes during exercise vary person to person, and are related to the type, intensity and length of exercise, as well as a person's fitness level, health status and usual blood pressure ranges.
In some people, blood pressure rises too much during exercise, even if they don't have high blood pressure, or hypertension. This exercise hypertension occurs when systolic blood pressure runs higher than 210 mm Hg in men or above 190 mm Hg in women, or when diastolic blood pressure readings during exercise are higher than 110 mm Hg in men or women. This condition is a risk factor for hypertension, if not already diagnosed, and is thought to be related to artery stiffness and increased peripheral resistance to blood flow.
Benefits of Regular Exercise
Regular physical activity is linked to reduced levels of blood pressure in the post-exercise and resting periods. Clinical practice guidelines for hypertension recommend regular aerobic physical activity for at least 30 minutes most days of the week. This amount of exercise is linked with a systolic blood pressure reduction of 4 to 9 mm Hg. A research review published in 2016 associates regular, medium to high-intensity aerobic activity with an average reduction of 11 mm Hg systolic and 5 mm Hg diastolic.
If you have hypertension, or if you have been told your blood pressure changes too much with exercise, talk with your doctor about personalized and safe exercise guidelines. When blood pressure is severely high, your doctor may recommend that you hold off on exercise temporarily, until your medications improve your blood pressure to a safer range. If exercise causes pain, dizziness, weakness or severe shortness of breath, see your doctor right away. Also seek immediate medical attention if you experience chest pain or pain in the neck, arm or jaw.
Reviewed by Kay Peck, MPH RD
Is This an Emergency?
- The Journal of Clinical Hypertension: Exaggerated Systolic Blood Pressure Response To Exercise
- American Heart Association: Understanding Blood Pressure Readings
- JAMA: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure The JNC 7 Report
- Pulse: Exercise Hypertension
- British Medical Journal: Physical Activity and Exercise Lower Blood Pressure in Individuals With Hypertension: Narrative Review of 27 RCTs
- IDEA Fitness Journal