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To Your Good Health: BP Rise With Exercise Is Normal, But Not That Much

Dear Dr. Roach: I am 68 and healthy. I exercise regularly, but my blood pressure is borderline high. At rest it is 140/90, with a heart rate of 56. I bought a blood pressure cuff to take my readings every morning. On a whim, I took it to the health club to see what it is when exercising. After getting my heart rate up to 110 on a bike, my blood pressure came in at 190/90. Are there studies to show what is “normal” when exercising? My doctor has not put me on any medication. — I.N.

Answer: Blood pressure often goes up with exercise, so the rise can be considered normal. However, it isn’t normal to go up as high as yours. The greater the blood pressure goes up with exercise, the higher the risk of developing high blood pressure at rest.

Your low pulse rate is probably a reflection of your regular exercise, and likely means you have a healthy heart. Even without any risk factors, however, many people do develop high blood pressure, and yours is likely to get higher. Cutting back on salt helps some people reduce blood pressure, and stress management also can help. However, if these don’t do the job, it is probable that you will need blood pressure medicine soon.

Some blood pressure medicines are more likely than others to affect your exercise ability, so be sure to talk to your doctor about that.

Dear Dr. Roach: I am a 63-year-old woman who went through an extremely easy menopause —zero hot flashes! When I went for my annual exam a couple years ago, I had a DEXA Scan that showed osteopenia, primarily in my spine. I was horrified! I increased my calcium and vitamin D-3 intake and worked hard at doing an indoor conditioning walking program on DVD. I lost 40 pounds (of which 10 have returned, unfortunately). I feel good for the most part, and I work 32 hours a week, spending 75 percent of my time on my feet.

This year it was time to have a repeat DEXA Scan, and the report wasn’t what I was hoping to hear. My hips have improved, but the density of my vertebrae stayed the same. “Do weight-bearing exercise. Continue with your calcium and vitamin D-3 supplements,” was the advice. Well, please tell me, what exercise will help my spine, which apparently wasn’t helped by walking? — S.T.

Answer: Walking is a great exercise, and I think you have done a great job. The walking surely is helping you feel good. However, for your bones, a little higher impact may be what’s needed to strengthen them up. Dancing, jumping rope and climbing stairs are all ways to get a bit more bone stress in your workout.

Bones respond to stress by strengthening, which is why bed rest is so deadly, and astronauts can suffer serious bone loss. Lifting weights is another great way to strengthen muscles and bones. Although there are medications to improve bone density, doing these exercises has so many more benefits, and many or most women can avoid medicines by doing what you are doing with vitamin D, calcium and exercise.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.