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Author: JDCRex Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 41146  
Subject: Blood pressure readings after exercise? Date: 11/13/2008 8:58 PM
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I exercise regularly (swimming and pretty hard aquajogging).

I've seen a doctor about 4 times (each time incidentally fairly soon after an exercise session - something like 1 to 2 hours out of the pool), and have recorded fairly high blood pressure readings. I have seen more normal readings when I drop into the chemist to get one done, but it's hard to get a handle on what might be soon-after-exercise related, and what could be "white coat hypertension" now that I'm nervous about the reading.

Does anyone know how long blood pressure is elevated for after a hard exercise session? What is a decent recovery rate? I'd really hate to have to go on medication for hypertension if it's not completely necessary.
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Author: sheila727 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32534 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/14/2008 12:00 AM
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I asked my husband about this. He's an exercise physiologist. And he has a few questions for you.

Do you know how quickly does your heart rate returns to normal?
What is your starting blood pressure, and what has it been at these doctor visits?

Heart rate should fall back below 100 in about 5 minutes, and be back to normal by 30 minutes at most. Blood pressure usually goes in parallel with heart rate. If it is still significantly elevated several hours after stopping exercise, then there is a problem.


sheila

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Author: JDCRex Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32535 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/14/2008 12:15 AM
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I asked my husband about this. He's an exercise physiologist.

Wow, thanks for that!

What is your starting blood pressure, and what has it been at these doctor visits?

I'm not really sure. I don't have a BP monitor, although I'm probably going to get one.

I have seen usual readings at the chemist of around 130/80, although I can't remember if that was after exercise or not. At the doctor's, the highest I can remember is something like 148/95. That was about 1.5 hours after a hard interval training session.

Heart rate should fall back below 100 in about 5 minutes

It's down under 100 within about a minute or so.

and be back to normal by 30 minutes at most.

My fully rested heart rate is normally somewhere between about 50 and 55. It's not down to that level within 30 minutes, though. After a hard exercise session, it'll be down to around 60-65 after 30 mins.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32536 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/14/2008 5:55 AM
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Does anyone know how long blood pressure is elevated for after a hard exercise session? What is a decent recovery rate? I'd really hate to have to go on medication for hypertension if it's not completely necessary.

It sounds counterintuitive but blood pressure is usually reduced after exercise in healthy individuals.....although most of the studies I've read in this context are only measuring up to an hour after exercise (doesn't mean no-one's recorded for longer......just that I haven't bothered to look) Yes, your heart might be pounding away but your blood vessels are wide open in the exercising muscles so the increased cardiac output doesn't produce the expected rise in BP.

It might well be that this is white coat hypertension since your heart rate seems to recover at a reasonable rate. See if you can find a good quality BP machine to record before, during and after exercise.

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Author: medgoddess Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32537 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/14/2008 7:50 AM
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have seen usual readings at the chemist of around 130/80,

*****************************************
In the abnormal range according to the guideline...want the upper number under 120 and the lower number under 80.


FYI
Kristi

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Author: pauleckler Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32538 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/14/2008 12:14 PM
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Every drug store these days has home bp monitors. The Omnicon models work very well. Cost about $60. Even discount stores have them.

Monitoring your own blood pressure is the best way to figure out your situation, and especially if white coat syndrome is one of the factors. Your bp is usually lowest when you first get up in the morning and then gradually rises from there (I think due to salt in diet if you are salt responsive like about half of the population).

By the way, there is a blood pressure board in Fooldom called Fools Under Pressure.

http://boards.fool.com/Messages.asp?mid=26209795&bid=116...

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Author: epc53 Three stars, 500 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32539 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/14/2008 5:42 PM
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Heart rate should fall back below 100 in about 5 minutes, and be back to normal by 30 minutes at most.

Everyone seems to agree that there should be an initial rapid recovery and that the amount of heart rate reduction in the first minute is predictive of problems but that 30 minute part seems to be at odds with this paper's discussion:
http://www.scielo.br/scielo.php?pid=S0100-879X2002000800018&...

where it says:
"The post-exercise exponential decline of heart rate is an intrinsic property of the intact circulation independent of autonomic control (4). Heart rate rapidly decreases during the first 1-2 min after the cessation of exercise, and gradually thereafter. During recovery from moderate and heavy exercise heart rate remains elevated above the pre-exercise level for a relatively long period of time (up to 60 min) ."

The benefit of exercising long enough for it to be "aerobic" per Cooper was that the heart rate remains elevated substantially after the end of exercise.

I recently visited my doctor after a 1.5 hr bike ride taking only enough time to shower and dress before driving to my appointment (about 40 min total). He noticed and questioned my still elevated heart rate (about 90bpm) but was entirely satisfied after I explained the timing of events.

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Author: OleDocJ Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32541 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/15/2008 6:48 AM
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I recently visited my doctor after a 1.5 hr bike ride taking only enough time to shower and dress before driving to my appointment (about 40 min total). He noticed and questioned my still elevated heart rate (about 90bpm) but was entirely satisfied after I explained the timing of events.

Denial (de Nile) is a long river in Egypt!!! Get yourself a bp monitor - they're cheap! Record your bp at various times throughout the day - say, 3, 4 or 6 times per day initially. Then, you can figure out when to monitor your resting bp and monitor it once or twice per day. When you've established your baseline, you can monitor it more infrequently.

You seem to think 130/80 is OK. I understand that. It used to be that anything under 140/90 was 'normal'. That thinking has changed. Now, the thinking is that 120/70 or a little less for your resting bp is what you should be shooting for.

Incidentally, the ACE inhibitors (e.g. lysinopril) are cheap as dirt and very effective. I take 20 mg per day. And, I have to say, that is the only Rx drug that I have ever taken that actually makes me feel better!!!

I frequently see readings of about 115/65 now; I used to read about 140/90 before lysinopril.


OleDoc

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Author: OleDocJ Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32542 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/15/2008 7:02 AM
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Incidentally, the ACE inhibitors (e.g. lysinopril) are cheap as dirt and very effective. I take 20 mg per day. And, I have to say, that is the only Rx drug that I have ever taken that actually makes me feel better!!!

As an afterthought, I should add that the major complaint that most people have about ACE inhibitors is that nasty dry cough! I have found that eating a couple of olives after taking the pill helps eliminate that side effect. (salt? vinegar? whatever, it works for me!)

I usually eat fruit for breakfast, so that is mostly K (potassium) intake. The ACE inhibitor favors K concentration over Na (sodium), so, taking a little extra Na helps (that's my rationalization).

I only get the nagging cough within an hour or two of taking the pill. Popping a couple of olives makes it go away within minutes!!!


OleDoc

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Author: rosewine Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32543 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/15/2008 8:32 AM
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It's interesting that some people get that nagging cough and some don't. I'm fortunate to be one of the ones that doesn't. I've been on 10 mg of lisinopril for several years and it certainly works for me. I definitely have a touch of the white coat hypertension and endorse getting a home monitor. They're cheap. They may not be as accurate as the ones in the docs office, but they do give you a trend line.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32544 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/15/2008 9:20 AM
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It used to be that anything under 140/90 was 'normal'. That thinking has changed. Now, the thinking is that 120/70 or a little less for your resting bp is what you should be shooting for.

Back when I was doing my pharmacology, this was the parameter. It wasn't so much that it was considered normal but that the side effects of the meds available back then (actually, before "then"....beta blockers were just coming on the scene in the UK) had such awful side effects....postural hypotension, drug induced hepatitis, profound depression etc......that the tradeoffs made compliance so difficult and skewed the risk benefit data a bit.

My mom squeezed a few really good years out of high BP secondary to renal artery stenosis with a combo of captopril, beta blocker and diuretic (tiny amounts of each gave good control with minimal side effects even though the cocktail seemed like "a lot" of drugs) Before captopril came on the scene she'd gone through methyl dopa (acute hepatitis) minoxidil (got as hairy as a werewolf) and it was only the fear of a second stroke that kept her taking her meds.

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Author: sheila727 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32549 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/16/2008 4:59 PM
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I asked my husband about this. He's an exercise physiologist....

And now I gave him your answers. Interestingly, he has a similar pattern to yours -- a very low resting heart rate along with slight hypertension.

And he has some comments. First, you need a better picture of where your blood pressure really stands. Either with a monitor that you've purchased, or at the chemist's, take your BP reading for 7 days in a row with the following conditions: pre-exercise, and at the time of day and routine.

If your resting BP is 130/90 and you're beyond 50, it's less a cause for concern. But if you're in your 50 or younger, try to lower it. His suggestion is a CoQ10 supplement, at least 100 mg/day. The quality and way the supplement is made are critical. I have no idea what to suggest for a reliable supplier, since I see that you live in Australia, but to educate yourself as to what to look for, read the CoQ10 fact sheet on epic4health.com. You'll also learn why CoQ10 can be so helpful.

I would add to that to take a hawthorn supplement, which has significant benefits for good cardiac function. There have been several randomized controlled trials showing benefit. Here's something with helpful background and dose suggestions.
http://xrl.us/oxjci
Ideally, I'd try to find a preparation that combines extracts from the leaf, flower, and berry rather than the berry alone. Nature's Herbs has an excellent one, but I don't know if it's available in Australia. But it shows you what to look for.
http://www.swansonvitamins.com/NH110/ItemDetail?SourceCode=I...

A good fish oil supplement should also help your BP, as well as being good for your health in a variety of ways.

I'm assuming that you eat what I call an anti-inflammatory diet, but if I'm wrong, then you need to minimize bad fats (trans fats, animal fats) and maximize good fats (olive oil, raw nuts and seeds, avocado). Reduce high-sugar foods and highly processed foods. Add fruits and vegetables. Pasture-fed meats, eggs from pasture-fed hens. Multi-grain breads and cereals.

If you can't bring your BP down with these changes, then my husband cautions that you need to see a doctor about it. And one important step will be to have a stress test -- but NOT the standard stress test, he says. For you, as an athlete, that is not appropriate -- though a great many physicians don't realize this. You have to insist on a CPET (Cardiopulmonary Exercise Test). The standard stress test is stopped when the patient reaches a certain predetermined heart rate, like 85% of their predicted maximal heart rate, or something similar. But the CPET goes beyond that, and doesn't stop until the patient reaches his/her peak exercise capacity. The standard stress test will not provide the results that are accurate for YOU.

My husband also has his own unofficial musings about this combination of low resting heart rate with slightly elevated BP. Looking at this as a pulmonary and exercise physiologist, he's not so sure it signifies a problem, though he can't convince any of the clinicians he's discussed it with. They all agree with his physiology-based reasoning, but they find themselves unable to go against the conventional dogma. This doesn't mean you should disregard a mildly elevated BP -- he certainly doesn't, with himself -- but he's sharing his musings with you.

If you have any further questions or concerns, please feel comfortable posting them here!


sheila

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Author: JDCRex Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32550 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/16/2008 7:20 PM
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Wow. sheila. Thanks greatly to yourself and your husband (and all others that have answered in this thread).

I'm younger than 50.

I'm going to get a BP monitor next week and start testing.

One thing to attack is my diet I think. It's not terrible, but I've got a pretty sweet tooth and I also get the Homer Simpson effect over salty biscuits.

I'd really like to avoid meds. I must admit that assuming it's true that I DO have high BP, I feel a bit ripped off by circumstances. In the leaflets and websites the advice is to stop smoking, drink less, exercise more, lose weight. Problem is I've never smoked, don't drink, exercise 6 days a week and fit into size 30 jeans with room to spare. There is the diet, though. Too much sugar, too much salt.

Once again, much appreciated! I'll post follow-ups.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32551 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/16/2008 10:38 PM
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If you can't bring your BP down with these changes, then my husband cautions that you need to see a doctor about it.

Assuming you have a chronic elevated BP the rational approach might be to seek medical intervention first....control the BP by predictable means and then institute the dietary changes and supplementation that might help over the long term.

The rationale being that, for every day that you walk around with an elevated BP (assuming that it is elevated)the microtrauma to organs that adds up to all the pathologic sequelae of uncontrolled high blood pressure is doing just that.....adding up.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32552 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/17/2008 8:56 AM
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Heart rate should fall back below 100 in about 5 minutes, and be back to normal by 30 minutes at most.

Everyone seems to agree that there should be an initial rapid recovery and that the amount of heart rate reduction in the first minute is predictive of problems but that 30 minute part seems to be at odds with this paper's discussion:
http://www.scielo.br/scielo.php?pid=S0100-879X2002000800018&......


The problem with bandying absolute numbers around (heart rate/time etc) is that it all depends on where you're starting, the work you're doing, the conditions you're working under and a whole slew of other variables.

In the interests of discovery, I did my am workout under strict conditions.....

I wore my heart rate monitor and watched it pretty closely.

I did the class I have planned for this evening.....the 3rd in a series of "strength" rides *AS ADVERTISED* on the weight training board http://boards.fool.com/Message.asp?mid=27163749&sort=thr... (don't know how to link to the whole thread)

I left my fan off so I provided myself with the worst conditions for recovery.

Finished the 50 minute ride with my HR monitor showing above 85% maximum heart rate but, since I'd spent about 40 minutes working with a heavy resistance and slow cadence (something cyclists tend not to do in the Real World) and since I wasn't gasping for breath, I assume a fair bit of cardiac drift here so didn't start my countdown till my HR reached 150 bpm. Was about 110 bpm about 5 minutes later and back down to about 80 bpm about 20 minutes later after my 3rd cup of coffee.

So....allowing for the extra heart beats you need for temp control on a stationary bike and allowing for the haemodynamics of the specific type of workout that I did, I fancy that sheila's husband's ballpark is fairly accurate for a fit individual.

You did notice that the subjects in the study were "untrained" didn't you? This makes a big difference to recovery.

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Author: sheila727 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32553 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/17/2008 1:24 PM
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I'd really like to avoid meds.

Don't blame you!

I must admit that assuming it's true that I DO have high BP, I feel a bit ripped off by circumstances.

Understandable resentment, but don't embrace it for too long. Try instead to regard this possibility as a gift--whether or not it turns out that you have an elevated BP!!

Your diet hasn't been great, and that's long-term not great. That's not good for your long-term health in a variety of ways, regardless of your BP. This possible concern has highlighted your diet, so now you have a chance to change it -- cut way down on what's harmful, and include a lot more of what's supportive. I'd hazard a guess that the problem is more than too much salt/too much sugar. My guess is that these are foods you buy, not make at home, and thus that they are also larded (no pun intended!) with bad fats and other unkind ingredients to make them taste better and/or stay reasonably fresh on the shelf longer. Why don't you post the full label ingredients of your most favorite things, and let's see!

So regardless of your BP results once you get your monitor and get a precise picture -- change is needed. And ALWAYS better when it's sooner rather than later! Consider yourself lucky.


sheila

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Author: sheila727 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32554 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/17/2008 9:01 PM
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I also get the Homer Simpson effect over salty biscuits.


I don't watch Homer Simpson, so -- this means??

Once you keep a week's log of your BP, if it is elevated, the first thing I'd do, actually, is cut out that salt and see what happens. For some people salt has little to no impact on BP. For others, it's a major player.


sheila

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Author: lggie Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32562 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/23/2008 12:08 AM
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May be placebo but I seem to have much better BP since adding "Red Beet Crystals" to my hot cocoa. Of course cocoa is a NO2 booster. The beet product is from Germany. Cheaper domestic beet powder may be just as good. http://www.myhealthpro.com/shop/detail.cfm?sku=D0124&rfr...

Iggie

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Author: thebigduece One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32565 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 11/23/2008 10:49 PM
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JDCRex

There is the diet, though. Too much sugar, too much salt.

I had the same problem. I starting baking my own cookies using Xylitol for sugar and using nothing but sea salt and sparingly. It seemed to work for me.

-The Duece

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Author: JDCRex Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32728 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 1/22/2009 2:24 AM
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Sorry -- was away for a while.

My guess is that these are foods you buy, not make at home, and thus that they are also larded (no pun intended!) with bad fats and other unkind ingredients to make them taste better and/or stay reasonably fresh on the shelf longer. Why don't you post the full label ingredients of your most favorite things, and let's see!

Yes, my diet is pretty up and down. It's by no means terrible - the base of it is ok (a fair bit of fresh fruit and vegetables) - but it's augmented with too much snack food and sweets. I honestly don't have a comprehensive list of ingredients, but it's safe to say that there's quite a lot of high sodium/high sugar empty calories. I do burn them off, but that's beside the point. You can guess what my New Year's resolution was. I could be doing better on it. though.

As for the BP - well. I bought a monitor, and am pretty shocked at how much it varies. Even the way I'm sitting and DEFINITELY the way I'm feeling (rushed vs not rushed) before and during the test can give quite different results. So does time of day. I'm pretty sure that my readings at doctors are elevated, but I'm keeping a diary for a couple of weeks and then going to see the doctor again with the data. From the difference I've seen in readings, I really don't trust a few anxious attempts in a surgery.

Once again, thanks to all.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 32729 of 41146
Subject: Re: Blood pressure readings after exercise? Date: 1/22/2009 5:09 AM
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From the difference I've seen in readings, I really don't trust a few anxious attempts in a surgery.

Your mistrust might be misplaced.

The variability of your blood pressure might actually be an indicator of an underlying problem....depending on how variable it is, of course.....and might be the result of some lack of adaptability in your cardiovascular system that ought to be able to compensate better for reasonable change in day to day activities and mood.

Heart rate and blood pressure are supposed to be flexible enough to vary beat to beat (this is a good thing) but your BP monitor measures more of an average that I fancy ought to reflect a responsiveness in your cardiovascular system to iron out changes so you don't get dramatic swings.

I suppose it's all a question of degree and is something your doctor should be able to analyse by eyeballing your diary.

Sometimes a high BP reading indicates "high blood pressure"

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