Hi Drs,
Yesterday I met a friend for dinner. He approaches 70. He spoke about his newly found fitness “hobbie”. Not that he was unfit. But now he has a smartwatch and his ambition is to clock 800 cal from activities on the watch every day. I know, it may not be accurate, still it is very significant activity. He mostly does row erg and playing golf/walking. He lost some weight and looks really good. He and his golf friends compete in the category “biological age” as their gadgets/apps calculate.
I think it is hilarious but I love it as this seems to make them more active.
His friends go to a gym with very fancy equipment (engineers…), he does not (yet). But I’m confident he will give in to peer pressure.
Now, the blood pressure question - he mentioned that he does rowing at 100-110 BPM max because at higher BPM his blood pressure is too high and that’s unhealthy/dangerous. I think he got that from an EKG he once did where he was told to get off the bike before the test was over because of the BP. Something like 230 at 160 BPM. Blood pressure is normal at rest. I remember that something similar happened to me during an EKG long ago but I didn’t care tbh, it certainly didn’t keep me from biking at all intensities back then and I’m still alive.
While 160 BPM is certainly exaggerated I guess higher than 110 could still be an added value for cardiovascular health.
I remember from one of the podcast episodes that high blood pressure when resistance training is normal and no problem as it is just a very short moment.
Does this also hold true for cardio, when the exertion is much longer?
Susanna
Hi Susanna,
Yep. Blood pressure increases during all activity and exercise, e.g. cardio, lifting weights, and everything in between.
Sounds like your friend may have been undergoing a stress test and they terminated it due to his blood pressure being elevated. Off hand, I believe the criteria for termination is ~ 250mmHg systolic and/or 115mmHg diastolic. At or above this level is termed “hypertensive response”, though there’s controversy about if this level should be lower, higher, and the significance.
Hypertensive response to exercise, e.g. the increase in BP greater than predicted, is poorly studied. We don’t really know what causes it, as it even happens in people without high blood pressure sometimes. There’s been some thought to treat these individuals with specific medications like angiotensin receptor blockers (ARBs) to reduce the blood pressure repsonse during exercise. Studies on this haven’t really shown a benefit in outcomes relating to heart disease, so a lot of this is still up in the air.
For your friend, as exercise intensity and/or fatigue goes up, we would predict a higher heart rate and blood pressure. Whether or not he should exercise at a level where there is no hypertensive response is mostly speculative. I would not feel comfortable advising him by proxy. If it were me personally, I would pay little attention to BP during exercise (assuming no symptoms like chest pain) and use exercise as a tool to improve fitness.
Just my 0.02.
-Jordan
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Sounds reasonable. That’s what I also did back then. I mean when you ride your bike up a mountain there is no way you’ll get off the bike just because the HR is higher than you like. Of course you try to stay at a rate / RPE you can sustain for long enough. BP has never been a consideration. If I suffered a heart attack now I strongly feel it would have other reasons than hypertension during exercise 15 yrs ago…