Because blood pressure can increase during exercise, some people who have high blood pressure are wary of workouts. The fact is, a variety of triggers, not just exercise, can cause blood pressure to rise or fall dramatically. Stress, fear, caffeine, or simply standing up too quickly can all play a role. Rapid changes that return to normal are rarely dangerous, but blood pressure that is consistently high, known as hypertension, is major risk factor for heart disease, stroke, kidney problems, and many other conditions.

The good news is exercise can actually control, reverse or prevent high blood pressure. That’s doubly good news for people with arthritis, who can get significant benefits from exercise and also tend to have high rates of hypertension.

This especially important for people with arthritis who have high rates of hypertension. “Recent CDC data show that about 53 percent of people with [all types of] arthritis have high blood pressure. For some types of arthritis and related conditions, such as lupus and rheumatoid arthritis, or RA, the prevalence is even higher,” says Jennifer Hootman, PhD, an epidemiologist who studies adult health at the Centers for Disease Control and Prevention in Atlanta.

Causes of High Blood Pressure

“Blood pressure gauges how hard you heart is having to work to pump blood through you body, or the force of blood against your artery walls,” says Chris Schumann, a clinical exercise physiologist at the University of Alabama at Birmingham. “A number of issues can cause hypertension. Arteriolosclerosis, fat buildup inside artery walls, for example, causes stiffening and narrowing of blood vessels, making it harder for your heart to pump blood. High blood pressure can also result from what’s called catecholamine circulation; these stressors, sometimes called ‘fight or flight’ hormones, cause veins and arteries to constrict, and your heart has to push against greater resistance.”

How Exercise Improves Blood Pressure

“Although exercise pushes up blood pressure during activity, once you’re done, there’s usually an immediate drop because the exertion releases vasodilators, factors that widen blood vessels and stay in your system for a few hours,” Schumann says.

The intensity and type of exercise you do and your level of fitness affect how much and how quickly blood pressure increases during activity as well as how quickly it returns to normal.

Sudden, extreme and unfamiliar exertion can mean serious problems. It can cause extreme spikes in blood pressure, putting people in a danger zone of cardiac stress that can lead to sudden arrest or heart attack.

Research has shown such exercise-related heart problems are rare. But a 2007 joint position paper on cardiac events and exercise published by the American College of Sport Medicine and the American Heart Association, states that some inactive people who go out to shovel snow off their driveway can and do have heart attacks.

People may hear stories of young, fit individuals who suddenly die while running a marathon. Such events are rare and are almost always caused by a pre-existing and previously undetected problem with the heart’s structure.

That’s why the less fit you are, the more important it is for you to avoid extraordinary athletic efforts, says Schumann. Moderate-level aerobic or resistance activities, such as brisk walking or lifting light weights, 30 minutes a day, most days of the week is recommended for people with arthritis and hypertension, says both Schumann and Hootman.

And once you start to work out, maintain a regular exercise routine. “Over time, regular exercise increases the availability of oxygen in your body and the heart works more efficiently, with fewer beats per minute.”

“What we know for sure,” says Hootman, “is that exercise can ease problems related to both arthritis and high blood pressure, improving quality of life and reducing the risk of heart problems down the road.”

The key, says Schumann, “is finding an activity you can do comfortably and regularly. The benefits of exercise are real, but to get them, you have to make it part of your lifestyle – permanently.”