Regular exercise is one of the best things you can do to prevent chronic disease and stay mentally and physically healthy. This is especially true if you have been diagnosed with high blood pressure or are at risk of developing it.

But for people with hypertension, spikes in blood pressure during and after exercise can be concerning. While it’s natural for your blood pressure to be higher after exercise, prolonged spikes can be cause for concern.

If your blood pressure rises significantly during exercise and remains elevated for several hours after exercise, you may have exercise-induced hypertension (EIH). This increases your risk of high blood pressure and other heart problems down the road.

Read on to learn more about how exercise affects your blood pressure and what to do if your blood pressure remains very high after exercise.

Exercise increases the demands your body places on your heart and cardiovascular system.

Your muscles need oxygen to move. To keep up with the demands of exercise, your heart must pump oxygenated blood harder and faster, moving it through your arteries and veins faster and with greater force. This increases your blood pressure.

Over time, as your heart improves, it becomes more efficient at pumping your blood. This lowers your blood pressure, including when you are resting.

According to the American Heart Association, healthy resting blood pressure is less than 120/80 mm Hg. The first number represents your systolic blood pressure, or the amount of pressure exerted on your arteries when your heart beats. The second number is your diastolic blood pressure, the measurement of pressure on your arteries as your heart fills with blood.

systolic pressure

Typical systolic blood pressure during exercise is below 210 mm Hg for men and 190 mm Hg for women. About 90% of people have readings below this measurement. If it’s higher than that, you may be experiencing EIH.

diastolic pressure

Exercise usually only affects your systolic blood pressure. Generally, your diastolic blood pressure stays the same before, during, and after exercise. If exercise affects your diastolic blood pressure, see a health care team.

In some cases, your blood pressure may rise to 250/110 mm mercury during peak exercise. Experts recommend stopping exercise if you reach 250/115 mm Hg.

In healthy people performing low to moderate intensity exercise, your blood pressure gradually increases in an upward curve as your exercise intensity increases. It then gradually decreases as the intensity of your exercise decreases.

In EIH, the curve becomes an exaggerated upward curve or peak. EIH is also called hypertensive response to exercise.

According to a 2016 study, when your blood pressure stabilizes after exercise, it’s often lower than before. This effect can last many hours. But with EIH, your blood pressure remains elevated after exercise.

Doctors define HEI as:

  • systolic blood pressure greater than 190 mm Hg for women and 210 mm Hg for men during exercise
  • resting blood pressure greater than 140/90 mm Hg after exercise

The Centers for Disease Control and Prevention (CDC) recommends waiting at least 30 minutes after exercise to take a reading and resting for 5 minutes just before.

But it may take a few hours after exercise for your blood pressure to return to its usual level.

If your blood pressure is still high but not a hypertensive emergency more than 2 hours after exercise, contact a health care team.

Generally speaking, the higher your fitness, the faster your blood pressure will return to your usual range. Keep in mind that typical blood pressure varies from person to person depending on genetics, lifestyle, gender, age, and ethnicity.

According to American Heart Association (AHA)A hypertensive emergency occurs when your blood pressure rapidly and severely reaches 180/120 mm Hg or higher and you experience any of the following symptoms:

If you experience any of the above issues, you should call 911 or local emergency services.

But if your blood pressure is 180/120 mm Hg or higher and you don’t have any of these symptoms, the AHA recommends waiting 5 minutes and rechecking your blood pressure. If it doesn’t go down on its own, call a doctor.

A study 2016 linked EIH with left ventricular dysfunction. It is the chamber of your heart that pumps blood to the rest of your body.

According to a study 2020, elevated blood pressure during exercise, and delayed blood pressure recovery after exercise are associated with various risks in middle-aged to older adults. These risks include hypertension, cardiovascular disease and death.

The study sample followed nearly 2,000 people, but almost all of them were white and of European descent. Further research is needed to examine associations between other ethnicities.

Knowing your blood pressure numbers before, during and after exercise and discussing them with a healthcare team can help prevent or reduce your risk of disease, according to one of the study’s authors.

Exercise-induced hypertension in young people and athletes

People with hypertension aren’t the only ones who experience very high blood pressure during exercise. Athletes and people who have not been diagnosed with hypertension can also have EIH.

In otherwise healthy young adults and athletes, HIE can be a sign of future hypertension or heart problems.

Research from 2019 found that young athletes without hypertension whose blood pressure increased significantly after exercise were 3.6 times more likely to develop hypertension over several years.

A 2020 study of middle-aged marathon runners linked EIH to an increased risk of atherosclerosis, a precursor to coronary heart disease.

Here are some reasons to see a doctor about your blood pressure during or after exercise:

  • Your systolic blood pressure rises above 180 mm Hg or your diastolic pressure rises above 120 mm Hg when you exercise and takes a long time to come down.
  • You have ever experienced a hypertensive emergency.
  • You have uncontrolled blood pressure.
  • You don’t have high blood pressure, but you do have EIH.

If you have heart attack symptoms, stop exercising and call 911 or local emergency services immediately.

Making lifestyle changes to improve your blood pressure is the best way to manage it before, during, and after exercise.

A health care team can suggest an exercise program, diet changes, or medications to help manage your blood pressure. Some medications impact your ability to exercise, so talk to a doctor before starting a program.

Here are some exercise tips:

  • Start slow and increase the intensity over time.
  • Check your blood pressure frequently and familiarize yourself with what is typical for you.
  • To be coherent.
  • Pay attention to how you feel when you exercise.
  • Warm up and cool down.
  • Choose exercises that you like and that you will respect.
  • Choose the right amounts and types of exercises.

A recent review of studies found that systematically increasing the time you spend on aerobic exercise helps lower your typical systolic blood pressure. Gradually increasing the intensity helps your diastolic blood pressure.

Other research has shown that the higher your resting blood pressure, the more helpful regular exercise is in lowering it.

Exercise helps manage your blood pressure

Regardless of your number, exercise is one of the best ways to manage your blood pressure, and it’s often the first line of defense recommended by medical professionals.

This is because your heart becomes stronger and more efficient with exercise, lowering your blood pressure all the time.

It can also help you achieve or maintain a moderate weight and prevent or eliminate obesity. Obesity is a significant risk factor for hypertension and many other heart and metabolic diseases such as diabetes.

People with high blood pressure can benefit greatly from including exercise in their treatment program. But some people with and without high blood pressure can get EIH. This is when your systolic blood pressure rises above the 90th percentile during exercise and takes a long time to come back down after exercise.

Too high blood pressure can increase your risk of heart damage, heart attacks and strokes. If you experience this type of high blood pressure along with certain symptoms, stop exercising immediately and call 911 or local emergency services.

To help manage your blood pressure during and after exercise, try the following:

  • Increase your exercise routine slowly and steadily.
  • Monitor your blood pressure regularly.
  • Manage your blood pressure by changing your lifestyle and taking medication if needed.