Does weight lifting raise blood pressure?

A young Arnold Schwarzenegger lifting weights

The answer is yes and no, but it’s important to distinguish acute from chronic blood pressure changes.  The immediate manifestation of a 600lb leg press is a profound spike in blood pressure.  In fact, clever real-time hemodynamic monitoring shows that systolic blood pressure can spike to over 400 mid “push”!  The physiology of this is astounding, and in part due to “bearing down” and clamping the major blood vessels in the abdomen.  The scariest part is that the heart must actually generate a pressure higher than this to move blood forward, and it does because we see that cardiac output is in fact maintained throughout the movement.  It’s brief, transient, and reaches baseline when you rest.  Phew, cerebral aneurysms can’t be cured with pre-workout drank.

The long term effects of resistance training are extremely positive though.  The following figure is from a meta-analysis from the Journal of the American Heart Association showing sustained blood pressure lowering in response to resistance training of greater than 4 weeks.  How this happens is less clear but I suspect the answer lies within expression patterns of circulating vasodilators, #genomics.  Even more interesting, but not necessarily surprising, is that combining weights with cardio (ie “dynamic” training such a CrossFit etc.) seems to yield a synergistic effect on blood pressure!  Gone are the days of 3min rest between sets.