Cardiovascular Disease Prevention Expert Forum
Blood Pressure During Sex
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Questions in the Cardiovascular Disease Prevention forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine.

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Blood Pressure During Sex

Hi,

My question relates to blood pressure during sex. I'm 29 years old, and have some family history of hypertension, so I'm very mindful of my blood pressure.  I check it regularly, and my resting BP is always around 115-125/75-85.

I became curious about what my blood pressure does during sex, so I decided to check it.  Halfway through, my blood pressure had elevated to 150/90, and at climax my blood pressure was 198/97. I didn't have any symptoms, aside from my heart racing and being a little out of breath.

Sure enough, within 5 minutes afterward it had gone down to 111/75.

My understanding, from my layperson's interpretation of medical literature, is that this is all completely normal. I've read things saying that it's not uncommon for a man's systolic BP to be 250 or even 300 at the peak of sex.

http://www.jamesgagne.com/Hypertension.shtml
http://www.reproduction-online.org/content/19/3/405.full.pdf
http://www.washingtonpost.com/wp-srv/national/longterm/viagra/stories/viagra060998.htm

My question is this, why is it safe for blood pressures to reach such levels during sex? I thought that if someone walked into the ER with a BP of 198/97 is that they would be considered to be in hypertensive urgency.  Obviously it's known that sex can precipitate cardiovascular events in people with diseased cardiovascular systems, but why do pressures at that level not routinely cause problems in healthy people, if such pressures are so dangerous?

I'm a layperson, but my guess would be that there's a difference between someone who has a BP of 198/97 for a few moments during sex, and someone who's presumably been walking around for a while with a BP of 198/97 (I.e. someone who walks into the ER with a BP that high and is deemed a hypertensive urgency situation.)

Again, I think that this is all normal, and don't need to talk to my doctor about this, but it's more so something that I'm curious about. Any explanation would be appreciated.

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You have done a very good job of explaining the fact that exertion raises the blood pressure within the body and causes the heart to work harder placing those vulnerable to coronary ischemia at risk.  The effects are over time and transient elevations are not as harmful as prolonged consistent elevations in blood pressure. You are correct that those blood pressure changes are somewhat normal
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