If your blood pressure increases significantly during exercise and stays high for several hours after you exercise, you could have exercise-induced hypertension (EIH). This increases your risk of hypertension and other heart-related issues down the road.

Consistent exercise is one of the best things you can do to prevent chronic conditions and stay mentally and physically healthy. This is especially true if you’ve received a diagnosis of hypertension or are at risk of developing it.

But for those with hypertension, blood pressure spikes during and after exercise might cause concern. While it’s natural for your blood pressure to be higher after exercise, prolonged spikes could be a cause for concern.

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

Language matters

We use “women” and “men” in this article to reflect the terms that have been historically used to gender people. But your gender identity may not align with how blood pressure affects your body. A doctor or healthcare professional can better help you understand how your specific circumstances affect your blood pressure.

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

Your muscles need oxygen in order to move. To keep up with the demands of exercise, your heart has to pump oxygenated blood harder and faster, moving it through your arteries and veins more quickly and forcefully. This increases your blood pressure.

Over time, as your heart gets fitter, it becomes more efficient at pumping your blood. That lowers your blood pressure, including when you’re at rest.

According to the American Heart Association, a healthy resting blood pressure is lower than 120/80 mm Hg. The first number represents your systolic blood pressure, or the amount of pressure on your arteries when your heart beats. The second number is your diastolic blood pressure, the measure of the pressure on your arteries when your heart is filling up 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 measure. If it’s higher than that, you may be experiencing EIH.

Diastolic pressure

Exercise usually affects just your systolic blood pressure. Generally, your diastolic blood pressure remains the same before, during, and after exercise. If exercise is affecting your diastolic blood pressure, check with a healthcare team.

In some cases, your blood pressure can rise to 250/110 mm Hg during maximal exercise. Experts recommend stopping exercise if you get to 250/115 mm Hg.

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

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

According to a 2016 review, when your blood pressure settles again after exercising, it’s often lower than before. This effect can last for several hours. But with EIH, your blood pressure remains high after exercise.

Doctors define EIH as:

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

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

But it can take a couple of hours after exercise for your blood pressure to return to its typical level.

If your blood pressure is still high but not a hypertensive emergency more than 2 hours after exercise, reach out to a healthcare team.

Generally speaking, the higher your physical fitness, the more quickly your blood pressure will return to your typical range. Keep in mind that typical blood pressure varies from person to person based on genetics, lifestyle, sex, age, and ethnicity.

Checking your blood pressure at home

If a doctor has given you a diagnosis of hypertension or you’re at risk of developing it, you may want to monitor your blood pressure. There are several options for at-home monitors you can use.

Here are some tips for checking your blood pressure on your own:

  • Wait at least 30 minutes after eating, smoking, exercising, or drinking alcohol or caffeine.
  • Rest 3 to 5 minutes before taking a reading.
  • The best times to take your blood pressure are in the morning before taking your medication and in the evening.
  • Check your blood pressure twice a day for a week, taking two to three readings in the morning and the evening. Each reading should be 2 minutes apart.
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According to the American Heart Association (AHA), a hypertensive emergency happens when your blood pressure quickly and severely spikes to 180/120 mm Hg or higher and you experience any of the following symptoms:

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

But if your blood pressure is 180/120 mm Hg or higher and you’re not experiencing any of those symptoms, AHA recommends waiting 5 minutes and checking your blood pressure again. If it doesn’t come down on its own, call a doctor.

A 2016 study linked EIH with dysfunction of the left ventricle. That’s the chamber of your heart that pumps blood to the rest of your body.

According to a 2020 study, higher 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 almost 2,000 people, but almost all were white and of European ancestry. More research is needed that looks at associations among other ethnicities.

According to one of the study authors, knowing your blood pressure numbers before, during, and after exercise and discussing them with a healthcare team can help you prevent or lower your risk of disease.

Exercise-induced hypertension in young people and athletes

People with hypertension aren’t the only ones who can experience very high blood pressure during exercise. Athletes and people who haven’t received a diagnosis of hypertension can also have EIH.

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

Research from 2019 found that young athletes without hypertension whose blood pressure rose 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 artery disease.

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

  • Your systolic blood pressure goes above 180 mm Hg or your diastolic pressure goes above 120 mm Hg when exercising and takes a long time to come down.
  • You’ve previously experienced a hypertensive emergency.
  • You have uncontrolled blood pressure.
  • You don’t have hypertension, but you’re experiencing EIH.

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

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

A healthcare team may suggest an exercise program, diet changes, or medication to help you manage your blood pressure. Some medications impact your ability to exercise, so talk with a doctor before beginning a program.

Some exercise tips include:

  • Start slowly and build intensity over time.
  • Check your blood pressure frequently and get familiar with what’s typical for you.
  • Be consistent.
  • Pay attention to how you feel when you’re exercising.
  • Warm up and cool down.
  • Choose exercises you enjoy and will stick with.
  • Choose the right amounts and types of exercise.

A recent review of studies found that systematically increasing the time you spend in aerobic exercise helps bring down your typical systolic blood pressure. Progressively increasing the intensity helps your diastolic blood pressure.

Other research has shown that the higher your resting blood pressure, the more helpful consistent exercise is in bringing it down.

Exercise helps manage your blood pressure

Regardless of your numbers, exercise is one of the best ways to manage your blood pressure, and it’s often the first line of defense healthcare professionals recommend.

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

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

Current exercise recommendations

The current (2022) U.S. physical activity guidelines for Americans recommend 150 to 300 minutes a week of moderate aerobic activity such as brisk walking or dancing, plus resistance (muscle-strengthening) exercise 2 days a week.

A 2015 literature review goes a step further, recommending moderate aerobic activity for 30 minutes most, if not all, days of the week, along with 150 minutes a week of resistance training.

A 2016 review of studies found that among nonwhite people, dynamic resistance training was as effective at lowering blood pressure as aerobic exercise.

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

Blood pressure that’s too high can increase your risk of heart damage, heart attack, and stroke. If you experience this type of hypertension 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 consistently.
  • Monitor your blood pressure regularly.
  • Manage your blood pressure with lifestyle changes and medication if needed.