Blood Pressure during strength training

What would make your blood pressure higher:
Doing a set of bodyweight pushups to failure (saying failure is around 50 or so)?
Or bench pressing to failure and just getting three reps?

I have a bicuspid aortic valve. One typical result is some weakness in the aorta. And people are told to avoid strenous weight lifting as it increases blood pressure too much. So my doctor tells me pushups are OK. But I should avoid bench presses. (I've ignored this advice in the past to the point of bench pressing 300 pounds without any issues but have decided to perhaps follow this advice now that I'm nearing 40 years old.)

So just curious, if anyone has any idea. I doubt the doctor actually does.

I mean of course blood pressure during the exercise. My resting BP is 110/70 thanks to being vegan the last 6.5 years. Before that it was already pushing up to 130, 135 as an omni and this current doctor says he would prescribe betablockers if it was that high as for this condition they really try to be careful to keep it very low.

If no one has any idea of the answer, that's fine. Just throwing it out there and I recognize that Pete is very knowledgeable about these things.

There will be some blood pressure increase in any exercise, basically the main increases are due to breathing, especially the holding of breathe or that tight breathing out under pressure (hissing type of breathe release). If you breathe normally your blood pressure as a rule doesn't go up so much...but you simply won't be able to lift as much, this is due to both a lower internal pressure & the fact you have to split your focus between breathe & bench work. So a person 'could' bench press for 3 reps if they focussed on normal breathing, but the totals would be much lower.
Obviously if a doctor has ruled out benching, then I wouldn't suggest you go against that.
I've seen several studies about BP & all sorts of heavy lifts, it tends to be the same for most lifts, the nearer the 1RM the higher the blood pressure goes, the most advanced a lifter, the higher they can make the internal pressure during the lift (hence you see nose bleeds, capillaries popping etc on powerlifters).
If I wanted to up strength & power with blood pressure issues I might consider Olympic lifting variations rather than powerlifting lifts. A powerlifter can grind out a heavy bench, dead or squat over quite a few seconds, whereas if you snatch (for example), yep you'd get an increase in blood pressure for a split second, then a second to steady the lift, then you drop it, safer for the blood pressure than a 10 or more second grinding lift with internal pressure held at max for all that time.
Obviously you couldn't do all the Olympic lifts, but variations, cleans, jerks off a rack, snatches would be 3 I'd think about.
It's something you really need to discuss with a specialist in the field I don't know the extent of the condition what risk category you're in. It may be that you shouldn't do any heavy lifting any more, if so you're going to have to find other avenues to explore (bear in mind that even things like push-ups pushed to the max can & do elevate blood pressure quite a bit towards the end of a grinding set for max reps).
My advice would be to re-learn breathing during lifting, basically you'll be learning to breathe the way that makes the lifts harder (so you'll lift lighter), most of us either hold our breathe or increase internal pressure by 'hissing' air during a lift, you have to move away from that & focus for a while on new breathe control techniques. To be honest it may be impossible for you hit things like 300 benches again using these new breathe techniques as without that stable base the muscles simply won't fire the same (it's a design feature of the human body), but I'm sure you can hit some impressive feats if you take the time to relearn how to breathe during training. You also have to accept a set ends when you lose control of your breathe, once normal breathing can't be maintained then the set is finished.
This is a hard one to work with as blood pressure only really stays in the 'red zone' during the lift, so any monitoring prior to or after mean little as it's the pressure during the lift that concerns us, but is hardest to monitor. You're going to have to be your own monitor, you can feel internal increases in pressure, so you'll have to learn to spot them & fight against the bodies natural tendency to increase pressure. This will increase the chances of injury with some lifts, but it's a trade-off you're going to have to make if you want to continue lifting.
Sorry I couldn't offer some earth shattering solution, but it seems just a case of doing what you can, trying out stuff & if you can't figure out a way to keep internal pressure low, then dropping that movement.

OK thanks. Yes, I saw a cardiac specialist. Had a cardiac MRI here recently. It seems I have the same moderate severity that I've had since I was 7. Moderate backflow through the valve. Ascending aorta dilated to 46 milimeters. (normal is maybe 38... possibly 40 for my size??) But the guy clearly didn't really know much about exercise though.

I was actually told when I was 7 that I should never even run and I would have to have open heart surgery by 15 at the latest. My parents decided to ignore that advice and go ahead and let me run and play. And ignoring the doctors back then worked out really well. But, yes, I want to be more careful nowadays. Thanks for the reply.

Sorry I couldn't offer more mate - that's often the problem, a person may be great at understanding the CV system, but have no exercise background (I've met a few specialists who, in my view are too specialised!). I'd say if you've lived with it ok & have used your own internal monitoring successfully I'd tend to stick with that as you seem to know your body pretty well. Just remember we all tend to get stupid when we lift as the testosterone peaks, so be prepared NOT to go for that extra rep or that max lift however much the "Mr Macho" inside you is saying "Go on you pussy!"

Looks like an article very much on topic of this discussion:

http://online.wsj.com/public/resources/documents/hb2.htm

"As a fitness trainer and health fanatic, Michael Logan knew that weight lifting could strengthen his bones and protect his heart.

What he didn't know was that it could be lethal. Mr. Logan had a bulge in his primary artery, the aorta. Knowledge of that bulge, or aneurysm, would have prompted doctors to allow only light-weight lifting. But like the vast majority of people with aneurysms, Mr. Logan didn't know he had one."

....

Heavy-weight lifting can spike blood pressure to dangerous heights. In maximum-effort lifting, which pits a participant against the most weight he can hoist one time, studies have shown that blood pressure rises to as high as 370/360 from a resting rate of 130/80. Conventional blood-pressure monitors can't even measure levels above 300. "At that level, nobody would be surprised if you had a stroke," says Franz Messerli, a hypertension specialist at the Ochsner Clinic Foundation in New Orleans."


Continued at the link.

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Thanks for the link. I wonder if a short term BP spike in a healthy person though is maybe a good thing. If maybe it strengthens the vessels...

I'd probably have thought it would be a good thing, within reason, rather like your muscles when training for strength, hitting them hard now & again, with plenty of recovery is actually good, it's overuse or pushing too hard that is bad (in my opinion anyway)

Pete wrote:

There will be some blood pressure increase in any exercise, basically the main increases are due to breathing, especially the holding of breathe or that tight breathing out under pressure (hissing type of breathe release).

That’s partly true. I also believe that some of the exercises that hypertensive patients do can trigger their blood pressure. Physical exercises are advisable but it is necessary that they always take medicines to maintain their blood pressure.

For more info: pulse oximeter