Blood pressure changes during heavy-resistance exercise

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease

“…When the Valsalva maneuver is used for the lifting of heavy weights, there is a superimposed increase in intrathoracic pressure, followed by a dramatic increase in systemic arterial pressure (802), with systolic pressures reaching 300 mm Hg or greater (803). As a result, most experts believe that heavy weight lifting or competitive athletics involving isometric exercise may trigger AoD and/or rupture and that such activities should be avoided (804).…”

Cardiovascular adaptation in athletes

“…The coordinated and often near maximal contraction of large skeletal muscle groups coupled with surges in catecholamine release cause transient increases in systemic blood pressure in excess of 400 mmHg. 5,6 From the perspective of the heart, isometric physiology imparts a "pressure" load that is focused largely on the left ventricle due to the fact that a competent mitral valve spares the remainder of a central cardiac apparatus. It has been shown that Valsalva physiology during isometric activity may reduce or negate the magnitude of left ventricular pressure overload due to the fact that simultaneous increases in intrathoracic pressure and intracardiac pressure effectively normalize transmural pressure, the principal determinant of myocardial work.…”

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary

“…When the Valsalva maneuver is used for the lifting of heavy weights, there is a superimposed increase in intrathoracic pressure, followed by a dramatic increase in systemic arterial pressure, 209 with systolic pressures reaching 300 mm Hg or more. 210 As a result, most experts believe that heavy weight lifting or competitive athletics involving isometric exercise may trigger AoD and/or rupture and that such activities should be avoided. 211 Working with patients on an individualized basis to streamline these goals based on insufficient data can be challenging.…”