Returning to the Gym with Elevated Blood Pressure May Mean Avoiding These Exercise Types
As we age, getting back to the gym is an important step for improving overall health. Regular movement improves heart health, circulation, strength, mood, and long-term independence. If your blood pressure is elevated—or diagnosed as high, you need to approach it thoughtfully.
Blood pressure reflects how hard your heart is working, how flexible your blood vessels are, and how your nervous system responds to stress—including physical stress from exercise. When blood pressure is elevated, exercise should support regulation, not overwhelm the system.
Understanding Blood Pressure (Simply Explained)
Blood pressure measures the force of blood moving against artery walls.
Normal BP: below 120/70
Hypertension: 130/80 or higher on repeated measurements in Canada. In other regions, 140/90. (4)
Even mildly elevated blood pressure places added strain on the cardiovascular system. Exercise is one of the most effective non-medication strategies to lower blood pressure—but only when it is applied appropriately.
Why Exercise Is One of the Best Tools for Blood Pressure Control
Strong scientific evidence (3,5,6) shows that regular physical activity can:
Lower resting systolic and diastolic blood pressure.
Improve blood vessel elasticity
Reduce sympathetic (“stress”) nervous system activity
Improve heart efficiency
Support metabolic health and weight management
On average, aerobic and resistance exercise can reduce blood pressure by 5–10 mmHg, which is clinically meaningful and comparable to some medications.
General Exercise Guidelines If You Have High Blood Pressure
Exercise programs in people with high blood pressure should be individualized. If you have not exercised after being prescribed medication for your hypertension diagnosis, you should consider consulting your physician and appropriate health professionals for your best path forward. Generally, you should:
· 30 to 60 minutes of daily moderate dynamic physical activity (Walking, Jogging, Swimming, or Cycling) (1,4)
· For hypertensive individuals with SBP/DBP of 140-159/90-99, use of resistance or weight training exercises does not adversely affect BP and can be utilized. (4)
Determinants of Variability During Exercise (6)
Age: Older individuals have a stronger systolic response likely due to increased arterial stiffness with ageing.
Sex: Testosterone increases vascular resistance while estrogen controls dilation.
Fitness levels: higher fitness may mean higher systolic blood pressure levels at peak loads.
Medication: Usually modulate high blood pressure peaks (but exaggerated responses to peak exercise may persist)
Genetics: Some factors may increase or decrease variability of blood pressure during exercise.
Why Some Gym Activities Can Cause Blood Pressure Spikes
Blood pressure naturally rises during exercise. This is normal as the demand on your body increases. However, certain movements and habits can cause excessive and rapid increase , particularly in people with elevated blood pressure or those returning after time away from training. (6)
These spikes do not add benefit—and may increase risk.
1. Heavy Lifting with Straining
Very heavy resistance training, especially lifting near maximal effort, can cause dramatic temporary increases in blood pressure—sometimes exceeding safe ranges. (6)
This does not mean strength training should be avoided. Evidence supports resistance training for blood pressure control when it is:
Generally moderate in load
Performed with controlled technique.
Not taken to muscular failure early on
Moderate resistance training has been shown to lower resting blood pressure over time when applied correctly. Don’t be a hero! Return to moderate intensity gradually and focus on a rhythm to allow your physiology to restore healthy benefits over time.
2. Holding Your Breath During Exercise (Valsalva Maneuver)
Holding the breath during exertion, known as the Valsalva maneuver, significantly increases blood pressure by restricting blood flow and increasing internal pressure.
This commonly occurs during:
Squats and deadlifts
Pressing movements
Heavy core exercises
Clinical guidance consistently recommends:
Exhaling during effort
Maintaining steady, controlled breathing
Avoiding breath-holding reduces unnecessary cardiovascular strain.
3. Jumping into Isometric Exercises like planking
Isometric exercise involves activating muscles and keeping them at a certain length for a chosen duration. This means you’re not moving joints but holding a static position. These exercises like sustained hand grip can cause significant increases in systolic and diastolic blood pressure.
This commonly occurs during:
· Planking holds
· Sustained hang grip exercising
Recommendation:
· Strength training that requires multiple (compound) joint use.
4. Jumping Directly into High-Intensity Cardio
High-intensity interval training (HIIT) can be beneficial for most, but returning to it too quickl, especially after inactivity, can overload the cardiovascular system.
For individuals with elevated blood pressure, guidelines recommend starting with:
Brisk Walking or jogging
Elliptical training
Rowing at a moderate pace
A practical rule supported by exercise physiology research: you should be able to speak in short sentences during exercise.
5. Overhead Exercises Without Adequate Control
Overhead lifting increases cardiovascular demand and requires good shoulder mobility, spinal control, and breathing coordination. Poor mechanics can increase neck tension and sympathetic nervous system activation.
If overhead movements cause:
Head pressure
Dizziness
Neck strain
They should be modified or temporarily avoided until control improves. This aligns with safety guidance for individuals with cardiovascular risk factors or poor mobility, control and coordination.
What a Safer Return to the Gym Looks Like
Generally, evidence-informed recommendations for individuals with elevated blood pressure include:
Gradual progression of intensity
Moderate resistance training
Emphasis on breathing and rest periods
Avoiding maximal efforts early on and consider factors influencing blood pressure response to exercise like age.
Consistency matters far more than intensity when blood pressure is involved.
Warning Signs You Should Not Ignore (2)
Stop exercising and seek medical guidance quickly if you experience:
Dizziness or light-headedness
Chest discomfort or pressure
Unusual shortness of breath
Visual disturbances
Persistent or irregular heart palpitations
Numbness
Difficulty Speaking
Back Pain (possibly new to you, or not explained by previous or current injury)
These are recognized warning signs and in some cases may be progressive and may require urgent intervention.
Final Thoughts
If your blood pressure is elevated, exercise is not the enemy—it is part of the solution.
The goal is not to push harder, but to move smarter, breathe better, and build long-term resilience.
At Near Me Therapy, we believe better movement—and better health—is always just a step away.
Not sure if returning to the gym is right for you? Book a Kinesiology assessment where our health professionals can assess your fitness and risk factors for returning to the gym and exercise today.
References
1.American Heart Association. American Heart Association Recommendations for Physical Activity in Adults and Kids. American Heart Association. Updated January 19, 2024. Accessed January 12, 2026. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
2. American Heart Association. Health Threats from High Blood Pressure. American Heart Association. Last reviewed August 14, 2025. Accessed January 12, 2026. https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure
3. Correia RR, Veras ASC, Tebar WR, Rufino JC, Batista VRG, Teixeira GR. Strength training for arterial hypertension treatment: a systematic review and meta-analysis of randomized clinical trials. Sci Rep. 2023 Jan 5;13(1):201. doi: 10.1038/s41598-022-26583-3. PMID: 36604479; PMCID: PMC9814600.
4. Goupil R, Tsuyuki RT, Santesso N, et al; Hypertension Canada Guideline Committee. Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care. CMAJ. 2025;197(20):E549-E564. Accessed January 12, 2026. https://hypertension.ca/wp-content/uploads/2025/05/Hypertension-guideline.pdf
5. Lopes, Susana et al. “Exercise training reduces arterial stiffness in adults with hypertension: a systematic review and meta-analysis.” Journal of hypertension vol. 39,2 (2021): 214-222. doi:10.1097/HJH.0000000000002619
6. Pesova P, Jiravska Godula B, Jiravsky O, Jelinek L, Sovova M, Moravcova K, Ozana J, Gajdusek L, Miklik R, Sknouril L, Neuwirth R, Sovova E. Exercise-Induced Blood Pressure Dynamics: Insights from the General Population and the Athletic Cohort. J Cardiovasc Dev Dis. 2023 Nov 29;10(12):480. doi: 10.3390/jcdd10120480. PMID: 38132648; PMCID: PMC10743421.
