Safe to run a marathon with high blood pressure?

Hi all,

I am 34, in decent shape, and have run 5 half marathons in the last year.  I was training to run the Paris marathon this year.

However, I have been diagnosed with high blood pressure (hypertension), and have since started taking medication (Nebivolol). 

My blood pressure is now under control, but prior to this was around 145/85 at home, and up to 170/100 when at the doctor surgery.

There is a history of high blood pressure in my family, and my 32 year-old brother is also about to start medication.

The worst thing is that my doctor advised me that I should forget all about running a marathon.  He said that there is a serious risk of brain injury if blood pressure goes up during a long, gruelling run. 

My question is:  Are there any other people in my boat out there who have been told the same thing?  Is it really as dangerous as my doctor is making out?

I really just wanted to run one marathon and that would have been it for me...





  • Second opinion from someone else at your surgery rather than a bunch of strangers on an internet forum maybe?
  • agreed :/ we often only hear what we want to hear, but you really do need to listen to the experts when it's a life or death situation. get a second opinion from another doctor, not the internet.
  • Don't get me wrong, I'm getting a 2nd opinion. And I'll get a 3rd if need be.

    The reason I am asking on here is because there are discussion threads where runners talk openly about taking medication for high blood pressure.

    My doctor was adament that this carries serious risks. So I was wondering what they were told by theirs.

  • Yes - you must get proper advice.  However, I had much higher bp readings (100/180+) than yours and was sent to  a cardio specialist - he was all for my marathon running.  In fact I got my GP into running when I was referred back to her for hypertension treatment. 
  • Agree with the others about getting medical advice, but perhaps your GP was seeing it more in terms of marathon distance @ Usain Bolt speed. In which case, totally understandable. 

    I've been off running these last 4 / 5 months due to a virus which has affected my heart and caused my BP to rocket, the readings being similar to yours.  The cardiologist I saw was all in favour of running, but in a controlled way, once I have recovered.

    I do HR training anyhow, but he felt that distance running at low HR would be excellent for my image.  Before becoming ill, my LSRs were 20m, during which I was able to keep my HR under control and (allowing for cardiac drift) quite low.  I know that HR training doesn't indicate BP, but you might want to consider changing to this form of training in light of your condition.

    However, your GP may also have been thinking about either the stress caused by racing or possibly, the side effects of the meds. 

    Either way, good luck.

  • Many thanks for your posts on this, all.  I really appreciate it.

    My guess is that my doctor is playing it ultra-safe.  But I really do not want to curtail my life's goals (such as running a marathon) because he's wrapping me up in cotton wool to cover his own backside.

    I've had and ECG and blood tests and they are all clear.  But I have hereditary high blood pressure (highest recorded being 170/100, but usually around the 145/85 mark.

    I am seeing a doctor this afternoon and will ask, but just thought it worthwhile asking what other doctors are saying to them.

  • have you been recently diagnosed........if so then maybe he's thinking that it would be unwise to go through such a long hard race pushing yourself to the limits when you have not had your blood pressure under cointrol for any length of time........

    racing a marathon is definitely diffent to training for one........

    don't you need a doctors certificate for Paris??

  • My BP has always been low, particularly since running, bottom readings around 65 - 70ish.  When I was ill, the bottom reading was regularly 90+.  I was turning in something similar to yours, 170 / 90 and higher.  I also felt ill and felt similar to the way I had when pregnant, when I had had complications with high BP.

    My GP said that my readings were normal and didn't seem to think it relevant that both readings were significantly higher than they usually were.  However, when I was pregnant, those were the sort of readings that prompted intervention. 

    It does seem that one GP's high BP is another one's low - and it does seem to contradict conventional guidelines.

  • You've probably always had high blood pressure (at least since adulthood), and you say you run 5 marathons a year, plus lots of training im sure.....and you havent died yet! So I'd be of the opinion you'd probably be ok, as long as you monitor yourself before, after, maybe even during (with a fancy heart monitor to check heart stress levels) and of course get the second opinion, maybe from a Doctor specialising in sport. 

    The doctor who said no running is probably just covering himself (as most doctors/physios now have to do. If you were to drop dead in a marathon your next of kin would no doubt want to sue the doctor who told you it would be ok to run. So the Doctor is just following NHS/Bupa guidelines and living in the land of caution). So I'd say you'd get your most honest opinion from a doctor, who posts on rw, knows running, but isnt actually treating you, and therefore can give you proper advice without the rist of legal issues. 

  • cardiac athletes

    I've been recommended to this website - may not be quite right for you as it's more cardiac than BP related, but you might find out a bit more by trawling around it.

  • High blood pressure can be very serious.  My wife's got up to190/120 before she had a bleed into the brain!  She has more or less recovered but it has taken years.

    Her  BP is fine now. 

    I would suggest that you get specialist advice from a consultant rather than just your GP

  • If I saw someone with a BP of 170/100 I'd be pretty wary of advising they were Ok to run a marathon. It's not arse-covering, it's quite liking your patient to not drop dead of a stroke or similar.

    Once your BP's under control, though, it shouldn't be a problem. If your ECG's clear the high BP obviously hasn't caused any strain on your heart, so don't give up on your dreams at the moment. image

    Regarding raised BP/raised BP in pregnancy....yes in pregnancy there is far more weight placed on deviation of blood pressure from "booking" readings (i.e. at the start of pregnancy) in order to trigger investigations for pre-eclampsia. However, I wouldn't call a BP of 170/100 "normal". image

  • I suspect there are 2 main issues- firstly it takes a wee while for the BP control to really settle, so you may still get increased variations in BP until you've been controlled on treatment for a while.

    Secondly, your drug sounds like a beta blocker- this will slow your pulse, and limit the extent to which your cardiac output can increase in response to demand- you may find you get faint if you push it- I would guess slow running would be less afected than any attempt at faster running, but it may be a problem.

  • This is late contribution but wondered how you got on? My bp varies hugely and I often think I should not run but seems to be best way of controlling my adrenaline which puts bp up! I ran Edinburgh with raised bp but went very steady 4 hr 15 and enjoyed every minute and recovered immediately but could I have done damage I not aware of?
  • Hi all,

    Well, the update is that I am still on Nebivolol 5mgs, which has brought my BP down to below 140/80.  However, I have also cut out processed meats and other high-salt foods (where possible), and this has further reduced my BP to about 125/75.

    I never did get to do the Paris marathon last year, as I was unable to get a Dr note, and unwilling to "come up with one" myself.

    I have, however, been given a guaranteed place in the VLM 2012, so I am now in training for that!

    I'm not a fast runner, and I'm not looking for a great time.  My training will consist of one, ever-increasing weekend run until I get up to 20 miles in April.  I plan on doing the marathon in under 5 hours (the closer to 4 hours the better).

  • All the very best with VLM and hope you don't mind another late entry here!  I also have hereditary HBP and have been on medication for about 20 years since about 30, unusual in an (at the time) slim, veggie, non-smoking, teetotal female apparently.  Over time my dosage (ACE inhibitor, lisinopril) has increased to 10mg but the BP itself is controlled - this morning (recovering from a bad cold) was 115/79.  I've run two hilly marathons in around 4 hours 30 and do a lot of off-road, long slow runs (LDWA type).  So it can be done but of course, everyone is different and you should of course take medical advice, but my surgery are very pro-running.  The key I think is to stabilise the reading and go from there.  One thing is, I could never get on with beta blockers, felt underwater with them, the lisinopril doesn't impact the heartrate at all so there is another option if you react to the blockers.     
  • Just to add my experience, I have fluctuational hypertension according to my GP and she refuses to put me on any medication even tho my BP can get really high. She says that in the absence of other risk factors there are more risks associated with long term medication. I should say I''m a lot older thn you, 55, bit have run for years, don't smoke or drink, and am slim, so I can't make any of the life style changes which is always the first recommendation. I get the opposite advice from the GP I see when living in Saudi Arabia, so it shows cultures/ medical establishments differ widely, because the doc in Saudi begs me to go on meds! At the momentv I'm following my British GP's advice because I hate taking pills and she has said I will probably need pills eeventually, just not yet. Don't know if this will help but it shows you have to research widely. All the best .
  • I am part way through investigation of a heart rhythm problem and have quite variable blood pressure depending on the time of day, 140/80 approx in the morning, perhaps slightly higher through the day and about 120/70 when I chill out in the evening.  When the doctor/nurse measures it it is about 200/100 but that is a really common problem named white coat syndrome. 

    The ideal BP is said to be 120/80 but it will vary on what you are doing, so to even have a chance of getting regular readings you need to sit down and relax for 5 minutes before taking the reading.  If you have a home reader keep a daily diary of morning and evening readings for a month and you will be able to get a more accurate averaged reading.

    As well as the change of diet which you have done one of the other things that is good for BP is exercise and my cardiologist has said to continue running even while my problem is being investigated but just cut back on pace work, and he shows no real concern at the levels of my blood pressure at the 140/80 level, though he will probably refer me back to my GP once they have discovered the heart problem.  They don't want me to take any drugs because some of them can have an effect on heart rhythm.

    If you look at something like the British Heart Foundation website there is a section on BP with recommendations for controlling it, as a runner you probably tick most of the boxes but it is a good reminder of what can help.

    Good luck with it

  • My doctor refused to sign my medical certificate for Paris and said my blood pressure was too high. But the guidelines for normal blood pressure have varied wildly over the past few years. Not so long ago 'normal' blood pressure was your age plus 100 - which would make my level well below.  Some say that big pharma pressurises the medical profession to change the guidelines so they can sell more drugs. It is normal for people who do a lot of exercise to have higher than normal blood pressures anyway, and regular exercise is prescribed to bring the level down.. So guess what - I ignored the doctor and ran anyway. I did 3.56.32 with no problems.

  • I should have added that my heart rate was 56 at rest.

  • booktrunkbooktrunk ✭✭✭

    My doctor knows I run marathons and the odd ultra. I'm on blood pressure tablets, and the doc thinks the running is good. That will do me. 

  • CormorantCormorant ✭✭✭

    UK NICE guidelines are to treat when BP is higher than 140/90. In the US they have a "pre-hypertension" band between 120/80 and 140/90. This could well be where big pharma and drugs come into it.

    Probably a good idea to get out of "pre-hypertension" with lifestyle changes if possible. I've just started a food diary and it's amazing where salt sneaks in  - he says after a croissant and a cheese and pickle sandwich!



  • I have been making efforts with the diet Mr Cormorant - those little black coffees in the morning are out. No more pizza, cheese or processed meats (sigh). Have also stopped drinking rehydration drinks - unnecessary  and 200mg of salt a go! My top reading is now down to 130 - so there is no need for drugs anyway.   

  • CormorantCormorant ✭✭✭

    Excellent Dave, good to hear that. I've been on max 2 decaffeinated coffees/day for 5 years following a brief arrhythmia episode kicked off by a ridiculous amount in one day. I started on decaff entirely and brought the odd one back in.

    I make my own pizza so I can control that quite well. Processed meats are tougher, I need to find a way of making something as good as ham without a ton of salt. Don't plan on making my own cheese any time soon though, so it will have to be moderation for that!

    As reported on other threads, not everyone is salt sensitive, but if it works for you and brings you under 140 then that's great.

  • 55 (next month) typical BP 192 over 130 pulse 57 I have done 1,357 training miles (said my Garmin 210), everything from 6 marathons to 102 park runs etc and I'm struggling to get doctors certificate to run overseas yet i feel great! strange how there was no doctors stopping the beastings during 13 years Army, or the stress of 22 years prison landings but want to run an overseas marathon roll out the cotton wool!

    here's my latest plea!

    1310hrs Sunday 14/06/15 lunchtime directly after 7.7 mile run to Reculver

    30 seconds after running inc 100metre sprint finish!

     2x measurements

    155/99 p107

    and again directly after that approx 2 minutes after running

    140/91 p70

     1315hrs Sunday 14/06/15 lunchtime 5 minutes after 7.7 mile run to Reculver measured above

     5 x measurements

    109/69 p77

    114/71 p75

    122/76 p77

    117/74 p73

    117/74 p68

     from the above measurements I conclude the running is doing me good?

    and I am infact a victim of raised blood pressure due to anxiety over medical intervention (white coat syndrome?) when measured by surgery nurse or Doctor, I have had very bad side effects on previous BP medication including hives on my neck and jaw line with clear fluids seeping from my pores! and on another medication urine incontinence overnight and permanent on going damage to my bladder cut off valve after urination.

    I  absolve of  any blame Doctors, Nurses and support staff of ***** Surgery I declare I am fit to run and should I not feel well on the day of the race I shall walk, retire, or not start

    Rick Ryder 17/06/15

  • Hi Rick - my sympathy to you. If you search paris marathon medical certificate you may find a solution.

  • thank you for the heads up Dave, just found my solution, my off sick doctor (torn Achilles) had popped in to surgery and has instructed locum to sign paperwork as he did last year for Rome so I'm cock a hoop looking forward to Moscow in September (but will file the Paris marathon link for future reference)

  • bev hartbev hart ✭✭✭
    This sounds so familiar! I have white coat (which is still a worry as it is STILL raised bp) and my readings would indicate that I should pop to hospital and not run the marathons, half marathons etc......but I do and my readings drop quite dramatically (as those from Rick do). Running does me good and I have convinced myself that being quite a hyperactive person with good cholesterol levels, non smoker, non diabetic and very slim that my chances of becoming unwell or having a cardio vascular incident are slight (my doctor agrees). Too many doctors look at one factor only....
  • Bev we can buy a motorcycle and ride around the Isle of Man at 200mph legally yet run a continental Marathon sheeewwww (sharp intake of breath!) I have told my wife and my Daughter..if it does all go pete tong.. its how i wanted to go! selfish i know. but whats the point being here if you do not get the chance to enjoy it? the up shot is i run to my comfort zone if i shave a bit off a pb so be it but the atmosphere, fellow runners and exploring the City are what its about for me

    oh i should mention the only slight issue i have ever had was a bit of a chest flutter running directly after eating Sunday dinner. note to self that's a big NO NO! about 3 years ago and i surprisingly managed to run through it.

    looking at cases of fatalities (during or after Marathons) there appears to be hidden /unknown heart issue or over stimulation by supplements as a cause

    just for the record I have raced motorcycles but i was never be brave enough for the TT course! they really are modern day Gladiators "I SALUTE THEM"

  • CormorantCormorant ✭✭✭

    If chest flutter is the same as heart palpitation (e.g. atrial fibrillation), it's a bad idea to run though it. Whilst your heart is beating irregularly you're at a much higher risk of stroke, so making it work harder is likely to be bad. Most likely it will recover of its own accord if you stop for a few minutes and you can then carry on running. If not, GP/cardiologist is needed to sort it out.



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