Elevated blood pressure the day after a long run.

? I am 54 years old, 123 pounds, 5' 3" and have been running all my life. I run at least five days a week, mostly three to five miles a day, though one day a week I do a long run. One Saturday morning, I did 10 miles. On Sunday, my blood pressure (BP) and pulse were taken. My pulse was in the 50s but my pressure was 150 over 87, the highest it's ever been. It's usually about 100 over 60 to 70; it used to be lower, but I have mitral valve regurgitation. [Editor's note: This is the backward leaking of blood in the heart from the left ventricle (lower chamber) to the left atrium (upper chamber).] My doctor says it's okay to run. What can cause such high BP? Am I overtraining?

Fran Richardson, Duncan, AZ

As long as the pumping function of your heart is normal, people with mitral valve prolapse or mild to moderate mitral regurgitation can exercise and are not precluded from competition. We even recommend exercise for people with poor pump function, but the exercise would be of a more modest degree.

Although our BPs tend to rise with age, a single BP evaluation is not a cause for alarm. Have your pressure checked again, several times, with a standard cuff--not a drug store machine. If it returns to normal, I wouldn't worry. Exercise is one treatment for elevated BP, and may be the only modality needed.

Overtraining syndrome is characterized by intensive training, often year-round, without allowing yourself enough rest between sessions. If you had this condition, you might be cranky, fatigued and feel worse after training rather than better. It does not involve higher BP, but higher pulse rates for relatively low workloads are not uncommon. It doesn't sound like you, but I do advise adequate rest between workouts.

Charles L. Schulman, MD, Cambridge, MA

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