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A question I recently received:
I am a 36-year old man with mitral valve prolapse. I take a low-dose blood pressure medication daily, and my blood pressure ranges from 113/68 to 136/80 depending on the time of day and my mood, what I'm doing, etc. I was told that because of my heart valve, I shouldn't lift weights. So I recently discovered Pilates and love it. But now I read that Pilates is isometric, and shouldn't be done by those with high blood pressure. I want to build strength and muscle, and I am so frustrated that it seems like I can't do it without risking my health!!!! Any advice?
I don't know where you read that Pilates is isometric, because it's not! In any movements you will have some muscles isometrically contracting to stabilize while others concentrically and eccentrically contract to move - even in walking.
I have never in 20+ years heard of Pilates being contraindicated for high blood pressure, and with medication yours is not that high. As long as you keep breathing and don't hold your breath as you force a movement you are fine. Just avoid positions where your head is below your heart (roll over, jackknife, rolling).
Quite frankly, an appropriate strength training program with correct breathing and biomechanics would be fine as well. You simply want to avoid straining while holding your breath (a Valsalva maneuver) which will force up your blood pressure.
So I would continue with Pilates, especially since you enjoy it!