What happens to blood pressure and heart rate with exercise? Cardiology Basics

What happens to blood pressure and heart rate with exercise? Cardiology Basics

In a normal person, the heart rate and blood pressure progressively increase with progressive exercise. The rise in blood pressure is mostly in the systolic pressure. Hence the pulse pressure is high during maximal exercise.

The maximum predicted heart rate is 220 – age of the person (Astrand’s formula) [1]. The increase in heart rate is needed in order to increase the cardiac output, to meet the demands of the exercising muscles. Systolic blood pressure and heart rate rise mainly due to the enhanced sympathetic activity. There is also a withdrawal of the activity of the parasympathetic nervous system.

Increased cardiac output due to increased heart rate and increase in stroke volume. Pulse pressure is increased because of the increased stroke volume and peripheral vasodilatation during exercise.

Now what happens to resting blood pressure and heart rate with regular exercise? Even though the heart rate and blood pressure rise during exercise, in the long run, it brings down both. With regular workouts for a long period, the body tones itself for the exercise. The rise in heart rate and blood pressure for a given level of exercise comes down.

That is why the resting heart rate of an endurance athlete is low, called as athlete’s bradycardia. Regular exercise is an important lifestyle modification for control of hypertension. Mild hypertension can be managed by a graded exercise program and a heart healthy diet, without any medications. Even those with higher levels of blood pressure, can start exercise programs after controlling hypertension with medications. This should be under strict medical supervision to check if there is undue rise initially with exercise.

Reference

1. Astrand I. Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand Suppl. 1960;49(169):1-92. PMID: 13794892.