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What happens to blood pressure when we exercise? Does it increase, decrease, or remain the same? If it does increase, why are patients with high blood pressure recommended to exercise?

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As pointed out in the answers above, your blood pressure increases transiently as you exercise because more oxygen and nutrients are consumed by your muscles. However, regular exercise increases your "cardiovascular reserve"-this means your body will be able to function well at lower blood pressures. However, caution must be taken in hypertensive patients whose blood pressures are already up the roof. In these patients, gentle exercise and life style modifications (diet, stopping smoking, weight loss etc) may reduce their blood pressures over time. This will also reduce their risk of cardiovascular catastrophes in the future.

So whilst exercise will reduce blood pressure, it is not recommended as a first line of life style modification in hypertensive patients because exercise itself is stressful initially and stress is also bad for a hypertensive patient. Hence, exercise is good but gentle exercise is recommended for hypertensive patients. But again I doubt gentle exercise will do maximum good to your cardiovascular system because the type of exercise that helps lower your blood pressure is one that makes you sweat (e.g tread mill, etc). But once the blood pressure of a hypertensive patient is under control, then they can safely exercise and this should help lower their blood pressure long term. I hope this makes sense.

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Blood pressure increases during exercise as shown in this paper, but the reason that experts recommend exercise for hypertensive patients is that increases in fitness decrease blood pressure (demonstrated nicely in this study of >2000 children, measuring fitness and blood pressure changes over 12 months).

In a way, the doctors aren't saying that exercise itself will decrease blood pressure, more: "increasing fitness will decrease blood pressure, fitness will increase with regular exercise, therefore you should exercise more."

Caution should be used though for taking up new exercise regimes and doctors should be consulted.

There are of course other well documented benefits to regular exercise and personally I find it is great stress relief which could indirectly aid lowering of blood pressure (stress increases blood pressure, mine is 80/50 - very low - and I would describe myself as quite easy going :D).

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Increases during exercise, but as we get fitter it decreases. Vessels become more optimal, they grow to supply muscles better, the heart beats less as it becomes more efficient. However this goes beyond that, hypertensive patients are at risk of stroke and heart attacks. Exercise reduces many risk factors: stress, obesity and coronary artery disease and many others. Thus exercise is really helpful.

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