GoodRx : How Does Blood Pressure Medication Affect Exercise? A Cardiologist Explains What to Expect

Key takeaways:

• Exercise and medications can work together to lower resting blood pressure. Both help prevent heart disease.

• Blood pressure increases as part of the body's normal response to exercise. Blood pressure medications can lower blood pressure at rest and stabilize it during activity.

• Most people don't notice a big difference when exercising on a blood pressure medicine. But a few of them are more likely to cause side effects while exercising.

Table of contents

Exercise and blood pressure

Effects of medication

Effects on heart rate

Type of exercise

Timing of exercise

When to get help

Bottom line

References

Igor Alecsander/E+ via Getty Images

Exercise has been prescribed as medicine since the time of Hippocrates. Its many benefits include lowering blood pressure, managing blood sugar levels, and improving mood. Still, many people also need medication to help manage their blood pressure.

Maintaining a normal resting blood pressure is essential for preventing heart disease. But what about working out while taking blood pressure medication? We'll discuss the effects of some common blood pressure medications and how they could affect physical activity.

Can you exercise while on blood pressure medication?

Absolutely! In fact, people with high blood pressure are encouraged to get regular physical activity. Regular exercise alone has been shown to lower resting blood pressure by a few points. Exercise and medications can work simultaneously to help lower your resting blood pressure and improve heart health.

If your blood pressure is elevated above normal, your healthcare professional might recommend you exercise and eat heart-healthy meals before starting medication. For blood pressure that's consistently high or very high, you'll likely need medication. Even athletes and people who exercise regularly should treat high resting blood pressure.

If you are curious about where your blood pressure falls, here are some numbers to help:

• Normal adult blood pressure is 90-120 mmHg systolic (top number) and 60-80 mmHg diastolic (bottom number).

• Elevated blood pressure is 120-129 / 80-89 mmHg.

• High blood pressure is 130-139 / 80-89 mmHg.

• Very high blood pressure is above 140/90 mmHg.

"Many people report that they feel better during exercise when their blood pressure is treated," said Lauren Sterrett, PA-C and exercise physiologist. "It is not uncommon to have symptoms with exercise that are from high blood pressure that go unrecognized until their pressure is controlled."

EXPERT PICKS: WHAT TO READ NEXT

• What are the best exercises to lower blood pressure? Learn about the aerobic and strength-training activities that are best if you want to lower your blood pressure.

• Can blood pressure medication make you tired? Some blood pressure medications are more likely to cause fatigue than others.

• Is your blood pressure medication outdated? A cardiologist explains what we know now about the best medications for blood pressure - and older ones that should be changed.

How does blood pressure medication affect exercise?

There are many types of blood pressure medications, and their effects on exercise will depend on the type.

ACE inhibitors

ACE inhibitors and ARBs are among the first-line medications for high blood pressure. Common examples are:

• Lisinopril

• Enalapril

• Valsartan

• Losartan

Both work by blocking the effects of an enzyme in the body that causes blood vessels to narrow.

By keeping blood vessels more relaxed, they help lower blood pressure. These medications won't lower your heart rate. This means they are generally well tolerated during exercise and in athletes.

Diuretics

Diuretics (sometimes called water pills) work to lower blood pressure by decreasing the amount of fluid inside the blood vessels. The most common type of diuretic used to treat hypertension is thiazide diuretics, such as:

• Hydrochlorothiazide

• Chlorthalidone

These medicines help the body get rid of extra water. They can also affect the electrolytes in the body. So, while the medicine itself won't affect how you feel during exercise, its effect on your hydration and electrolytes can. In order to avoid any problems, it's important to:

• Drink enough fluids when you exercise to avoid dehydration.

• Make sure to warm up and cool down when exercising to avoid dizziness.

• Avoid strenuous activity in hot weather.

• Pay attention to symptoms that could mean your electrolytes are abnormal. These include muscle cramps, palpitations, or feeling weak or dizzy.

If you experience these symptoms, stop your workout. Get in touch with your primary care provider or cardiologist, who may want to check your electrolytes before you resume your regular exercise routine.

There are two more types of blood pressure medications that we will discuss in the next section.

Will blood pressure medication affect heart rate during exercise?

Some blood pressure medications affect heart rate, and others don't. Many times, the ones that lower heart rate are better for people with heart rhythm problems or heart failure.

Two types of blood pressure medications that can lower the heart rate are:

• Beta blockers

• Calcium channel blockers

Beta blockers

Beta blockers work by blocking adrenaline receptors on the heart, making it beat more slowly. Common beta blockers include:

• Atenolol

• Carvedilol

• Labetalol

• Metoprolol

• Nadolol

• Propranolol

Because beta blockers lower heart rate at rest and during exercise, some people feel more fatigued than normal during activity.

Calcium channel blockers

Calcium channel blockers prevent calcium from entering the cells in your heart and blood vessels. This reduces pressure on the heart and relaxes the blood vessels. Common calcium channel blockers are:

• Amlodipine

• Nicardipine

• Diltiazem

• Verapamil

Although the main effect of calcium channel blockers isn't slowing the heart rate, they can have a small impact on the heart rate. But they are typically tolerated well in active people with few side effects.

Does it matter what type of exercise I do while taking blood pressure medicine?

When it comes to type of exercise, variety is most important. This will not only give you the most benefit for your health, but it can also help keep your workouts fun and interesting. A well-rounded workout routine can help maintain endurance, strength, balance, and flexibility. These are all particularly important as you age.

When it comes to blood pressure, it's been shown that dynamic exercise can even lower blood pressure in a matter of hours. And these benefits tend to be more pronounced in people with high blood pressure in particular. Dynamic exercise is anything that involves moving the body through a full range of motion. Examples include push-ups, jogging, lifting weights, or dancing.

Isometric exercise also helps lower your blood pressure, but it just takes more time. In other words, it won't lower your blood pressure immediately like dynamic exercise. Isometric exercise involves contracting a muscle without moving your joints. Some examples are planks or wall squats.

No matter what exercise you choose, regular activity leads to a lower and more sustained decrease in blood pressure - as long as you can sustain it. At the end of the day, the best exercise is one that you enjoy and can stick to.

It's also important to make time to warm up and cool down with any workout regimen. This helps avoid injuries. Cooling down also gives your body time for the heart rate and blood pressure to slowly return to baseline. With any exercise program, start slowly and gradually increase activity to prevent injuries and stay motivated.

Should you exercise before or after taking your blood pressure medication?

You can exercise before or after taking your medication. It's more important to take the medication at the same time every day. Since medications wear off after a certain period of time, a consistent schedule keeps blood pressure stable. Take note if you feel tired when taking your medication before a workout. Your healthcare professional can help adjust your medication to a schedule that makes sense.

When to talk to a healthcare professional

Talk with your primary care provider or cardiologist anytime you have questions about a medication, new or old. Pay attention to how you feel when you start a new medication or when your medication dose is adjusted. Sometimes, it can be difficult to tell if your symptoms are related to medication. So, it's helpful to keep track of symptoms and medication timing.

If you feel that your medication is interfering with your activity, tell your healthcare professional. They might adjust your dose or do other tests like a heart rate monitor or a supervised exercise test.

With any medication, it may take time for your body to adjust. Plan to start with low-intensity exercise around the time of new medicines or doses. Here are some red-flag symptoms that should prompt you to talk to your healthcare professional right away:

• Dizziness that doesn't get better when you stop exercise

• Chest pain

• Passing out during or after exercise

• A major decrease in what exercise you're able to do

• Blood pressure that's persistently low at rest (<100/60 mmHg), especially with symptoms

The bottom line

High blood pressure is very common, and many of us will need to be on medication for hypertension at some point in our lives. But that shouldn't keep you from getting regular exercise. Most people on blood pressure medication don't recognize a significant impact on their physical activity. In fact, regular exercise can help in managing high blood pressure, either alone or with medication. As with starting any new medication, talk with your healthcare professional if you're concerned about side effects. They can help you choose the right medication and dose to manage your high blood pressure.

References

American Heart Association. (2024). Getting active to control high blood pressure.

American Heart Association. (2024). Types of blood pressure medications.

View All References (6)

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Edwards, J. J., et al. (2022). Exercise training and resting blood pressure: A large-scale pairwise and network meta-analysis of randomised controlled trials. BMJ Journal of Sports Medicine.

Niedfeldt, M. W. (2002). Managing hypertension in athletes and physically active patients. American Family Physician.

Pescatello, L. S., et al. (2004). Exercise and hypertension. Medicine & Science in Sports & Exercise.

Pescatello, L. S., et al. (2019). Physical activity to prevent and treat hypertension: A systematic review. Medicine & Science in Sports & Exercise.

Pescatello, L. S., et al. (2021). Do the combined blood pressure effects of exercise and antihypertensive medications add up to the sum of their parts? A systematic meta-review. BMJ Open Sport & Exercise Medicine.

Tipton, C. M. (2014). The history of "exercise is medicine" in ancient civilizations. Advances in Physiology Education.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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