Exercising When You Have Low Blood Pressure

Regular exercise is important for everyone to stay healthy and mobile. However, with low blood pressure — also called hypotension — you may need to tweak your exercise regimen if you're feeling symptoms like dizziness or fatigue. Here's what you need to know about low blood pressure and exercise.

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As explained by the American Heart Association (AHA), blood pressure is comprised of two numbers: systolic, the top number, which indicates the pressure of blood in your arteries during heartbeats; and diastolic, the bottom number, which measures the pressure of blood when the heart rests between beats.

The AHA notes that a normal blood pressure reading is 120/80 millimeters of mercury (mm Hg) or below. Elevated blood pressure is when readings consistently range from 120 to 129 systolic and less than 80 mm Hg diastolic. Above that, and you're dealing with high blood pressure, also known as hypertension.

On the opposite end of the scale, low blood pressure is a reading of less than 90/60 mm Hg. Unlike high blood pressure, hypotension on its own is not cause for concern, according to Jonathan Whiteson, MD, director of rehabilitation medicine at NYU Langone Medical Center in New York City.

It's only when you're experiencing symptoms related to hypotension — such as dizziness, nausea, feeling lightheaded, fatigue or disconnected and confused — that it should be checked out, Dr. Whiteson says. Because your heart is working differently, and often harder, when you exercise, that's when symptoms like these might crop up, he says.

Before starting any new exercise program, it is important to have the cause of your low blood pressure properly diagnosed. According to U.S. National Library of Medicine (NLM), hypotension could be caused by dehydration, heart failure, nerve damage from diabetes and changes in heart rhythm. Alcohol consumption can also be a factor, as well as certain medications like diuretics, painkillers and antidepressants and anti-anxiety drugs.

Your blood pressure can also drop when you change positions too quickly, a condition called orthostatic hypotension. NLM notes that this type of low blood pressure usually lasts only a few seconds or minutes.

Once your doctor has diagnosed the underlying problem, then the correct exercise program can be developed.

When exercising, take precautions to help stabilize your blood pressure. Because your body needs blood to digest food, eating smaller meals before exercise can help, according to Natasha Trentacosta, MD, a sports medicine specialist and orthopedic surgeon at Cedars Sinai Kerlan-Jobe Institute in Santa Monica, California.

She also recommends changing positions slowly, such as standing up after doing exercises on a bench or the ground, to prevent orthostatic hypotension.

"If you're doing exercises like bicep curls on a bench, for example, and you suddenly stand up to switch weights, your blood vessels don't have enough time to adjust their pressure," she says. "That can bring on symptoms like dizziness, headache and even blurry vision."

Also remember to drink plenty of fluid. If you're dehydrated, it means that your body is losing more water then you're consuming, and not only can that worsen low blood pressure, but NLM notes that dehydration symptoms can also mean dizziness, fatigue, excessive thirst and dry mouth.

If you have hypotension and plan to work out, make sure you hydrate properly, Dr. Trentacosta says. If you are participating in vigorous exercise, you may need to drink a sports drink that contains electrolytes as well. Each person's need for water is different, so your doctor can recommend the proper fluid intake based on your personal health.

If your low blood pressure stems from a heart condition, diabetes or other serious condition, your doctor will set exercise limits, Dr. Whiteson says. Once you're cleared to work out, take time to properly warm up and cool down so that your heart rate slowly climbs and lowers, he says.

Increase the intensity level of your exercise gradually and slow down if you notice symptoms such as weakness, unusual fatigue, an irregular pulse, confusion or dizziness. After your workout, stretch while standing or sitting down versus lying down, and remember to change positions slowly, Dr. Trentacosta says.

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