Is There a "No Go" Blood Pressure?

[sportive.tricks]

I am 43 years old and have had high blood pressure for about ten years. It is difficult to control and usually stays above the current medical target of 120/80, but below the old school one of 140/90. It does go higher, all too often lately, and I have been scrambling to get it down further as I realized I'm in my forties. (I just found out that I still have sleep apnea despite two surgeries for it 8 and 9 years ago.)

Anyway, I am working so hard on this that I think I am annoying my doctors, but I am certain I will get the BP fully under control soon. In the meantime, I'm terrified of damaging or further damaging my cardiovascular system (does anyone want an aortic dissection?). With the BP# fluctuations I have (probably from diet and/or sleep position with that OSA) does anyone have any suggestions about a resting BP reading that should mean I avoid the gym? I've been roughly working with 140/90--if I'm much above that number I delay my workout or do cardio/HIIT instead. Alternatively, is this a dumb approach since my BP will go far higher during work sets anyway and the issue would be the elevated pressure over weeks and months and years? I am definitely capable of coming up with dumb approaches.


Aside from that question, I'll mention that I really think strength training has kept me safe and healthy while I have had high blood pressure, not the other way around. I've just seen a lot of folks suggesting that maybe people shouldn't lift until their blood pressure is under control. Mine has not been (according to the latest guidelines) for ten years, and I lifted somewhat heavy anyway)

Thanks!

[Pete Troupos]

If you search around the forums, you'll see a few discussions on the topic already.

Why do you have high blood pressure?
Why are you concerned with aortic dissection?

[sportive.tricks]

If you search around the forums, you'll see a few discussions on the topic already.

Yeah, I've spent about two weeks reading what's been said here about HTN and lifting. I've largely been convinced of something I already suspected: that strength training is good for blood pressure, not the other way around. But I do often see authorities on these boards saying maybe people should wait for blood pressure to be under control (through the use of antihypertensive medications, I assume. They just never seem to be able to get me all the way down to 120/80 or below.)

Why do you have high blood pressure?

That's the million-dollar question. I'm a pretty frequent drinker, which could be driving it up, so I am working on cutting back on the 2-4 beers or whiskey snifters I have at the end of the day. I also have obstructive sleep apnea, and I am working on getting new treatment for it. I think the nighttime drinks probably make the OSA worse, and therefore the blood pressure, so I am really focusing on getting out of my alcohol habits. (It takes time, though).

Anyway, the specific question I'm asking here is if we can determine a resting blood pressure that's too high for hitting the gym. As I said, I'm working with about 140/90. So if my BP is, say, 127/88, I go to the gym and train. But if it's, say, 145/94, I hold off until later in the day or until the next day. Maybe that's dumb, but I wanted to hear what SS coaches thought, especially if they work with hypertensive trainees.

Why are you concerned with aortic dissection?

I read some medical studies on anecdotal reports of young men suffering dissections while lifting. I do worry that I've possibly caused damage to my vasculature by lifting somewhat heavy with resting BP that has not fully responded to medication.

But the short answer is that I have anxiety problems and read that shit.

[PizzaDad]

I am not a coach. I first read this last night. I didn't comment because I didn't want my response to sound like I was making fun of your concern. I don't imagine that aortic dissection or avulsion is a big enough issue to contraindicate strength training. I think that if you are really worried about this, you should see a cardiologist and get an echocardiogram. They can probably detect if you have an enlarged aorta. You are probably worrying about nothing, but I got a heart scan performed a couple years ago after a friend who was in better shape and younger than me had a heart attack. It set my mind at ease. My friend still lifts and does BJJ several times a week. His cardiologist approves.
I can't remember who it was .... who said "dying under a heavy squat is acceptable. Dying in a boardroom is not." I'm sure I bastardized that quote, but at a certain point, you just have to decide if you are going to allow fear of what might happen stop you from something you want to do. There is lots of shit out there that might hurt you. But most of it never does.

[Pete Troupos]

Sportive
Without knowing you or your entire medical history, I can only say that there's a lot of information pointing to the beneficial effects of resistance training on folks with hypertension or that are pre-hypertensive. I don't know of a "red line" diastolic or systolic number where you should absolutely not train. That's not to say there isn't one. Anecdotally, I've had clients train with higher blood pressure than you've listed and they haven't had any issues.

Have you ever checked your blood pressure 30-60 minutes after you've trained?

[sportive.tricks]

I am not a coach. I first read this last night. I didn't comment because I didn't want my response to sound like I was making fun of your concern. I don't imagine that aortic dissection or avulsion is a big enough issue to contraindicate strength training. I think that if you are really worried about this, you should see a cardiologist and get an echocardiogram. They can probably detect if you have an enlarged aorta. You are probably worrying about nothing, but I got a heart scan performed a couple years ago after a friend who was in better shape and younger than me had a heart attack. It set my mind at ease. My friend still lifts and does BJJ several times a week. His cardiologist approves.
I can't remember who it was .... who said "dying under a heavy squat is acceptable. Dying in a boardroom is not." I'm sure I bastardized that quote, but at a certain point, you just have to decide if you are going to allow fear of what might happen stop you from something you want to do. There is lots of shit out there that might hurt you. But most of it never does.

Thanks for your response, and I certainly do not think you are making fun of me. To be clear, I don't really think my HTN puts me at anything more than a minimally increased risk for aortic disease. The question is if there is a resting BP number that would cause SS coaches to think twice about putting their trainees under the bar. The answer (which I expected) seems to be no.

I also fully agree with your thoughts on the risks of training: I think strength training does FAR more to improve overall health and reduce risks than it could possibly do to increase them. That said, I DO envy you getting the echocardiogram and peace of mind from your cardio; the last time I went to see one, they simply refused to give me the screening.

[sportive.tricks]

Sportive
Without knowing you or your entire medical history, I can only say that there's a lot of information pointing to the beneficial effects of resistance training on folks with hypertension or that are pre-hypertensive. I don't know of a "red line" diastolic or systolic number where you should absolutely not train. Anecdotally, I've had clients train with higher blood pressure than you've listed and they haven't had any issues.

Have you ever checked your blood pressure 30-60 minutes after you've trained?

Thanks, Pete. This very much answers my question and puts my mind at ease about continuing to train. Let's keep fingers crossed that doing so, further cutting back on alcohol, and resolving the sleep apnea will get that BP down for decades to come.

Thanks!

[Mike Troxell]

Dr. Sullivan addressed BP and barbell training. I also have higher blood pressure, but do not check it prior to working out. It sounds like you check it very frequently and may be raising your numbers; "white coat syndrome."

Hypertension and Lifestyle Factors | Jonathon Sullivan

[Pete Troupos]

Thanks, Pete. This very much answers my question and puts my mind at ease about continuing to train. Let's keep fingers crossed that doing so, further cutting back on alcohol, and resolving the sleep apnea will get that BP down for decades to come.

Thanks!

You've seen a physician, have they prescribed any meds?
Also, to clarify my point, I don't know of a "red line", but that doesn't mean there isn't one. When I go to find definitive information, I see numbers all over the place.

[Nockian]

Go check with your doctor if you need meds take them. Keep a check on blood pressure that it isn't staying consistently high-high is different for everyone, based on age, exercise, stress, history, weight, smoking, drink, diet, hereditary factors. My blood pressure is now up in the 170/100 mark at times so I needed meds. There is a family history of high BP, but I have low risk factors. I'm happy with my BP 140/90 and I don't worry about lifting. My doctor is aware of all the factors and I send him home readings of my BP and he works with me to manage it.

One word of advice. Don't let BP rule your life. It can become an obsession, with every spike reading creating the stress that feeds the next higher reading. I get anxious just putting the cuff on my arm and the BP spikes, then seeing the numbers gets me more anxious. It can make readings highly inaccurate so you have to be careful to take this into account and be sensible.