How does elevated heart rate/blood pressure from working out differ from other sources?


Elevated heart rate/blood pressure is often cited as a benefit of working out but a negative side effect of many vices such as nicotine. Why is it healthy in one scenario but not the other?

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It’s not really that increased heart rate is healthy in one scenario and not the other, it’s that exercising is healthy and consuming loads of nicotine isn’t and your resulting heart rate is a very obvious signifier of both. It’s not dissimilar to how heavy breathing whilst running is considered normal but heavy breathing whilst eating a croissant isn’t, or how massive pupils are good when you’re stargazing but less so when you’ve taken four ecstasy pills.

Of course, part of what makes exercise (as opposed to a death march through Siberia) healthy is that it’s typically a short, controlled surge in bodily functions (including increased heart rate) where as part of what makes diet-induced excesses bad is that your heart is going like the clappers for an extended and difficult to reduce time.

When you exercise, you’re conditioning/strengthening your heart. You’re teaching it, by slowly increasing your reps/distance, to be a bit stronger. People who workout often tend to have a lower resting heart rate & lower blood pressure because they’ve strengthened their hearts. When working out, it also takes longer for those who regularly exercise to meet their maximum suggested heart rate than it would for those unused to the intensity. High blood pressure or an increased rate from outside sources can be detrimental on the heart because it hasn’t been conditioned/strengthened, so it can’t handle the increased workload/frequency.

In exercise, your heart rate and blood pressure go up for a while, then come back down. That helps your body stay regulated and work better.

But your heart can’t safely beat fast forever, and high blood pressure over long periods of time stiffens your heart muscle and damages your organs.

With long-term nicotine use, your heart and organs just never get to rest. And that wears everything out way faster.

There’s a lot of things that happen during exercise that don’t happen when your heart is beating hard from other sources.

There are changes physiologically, i.e. you increase your hearts ability to deliver oxygen to your lungs capillaries, increasing efficiency of how you deliver oxygen to your tissues.

There are changes cellularly, like increasing the number of mitochondria (the things that make energy in your cells), and increasing how efficient those work.

There are transient changes in your vasculature in terms of endogenous hormones and metabolites that can change your blood lipids and prevent atherosclerosis and other changes from happening (or slow them or even reverse them).

In general, we want to keep our heart rates and blood pressures in a normalized range, because otherwise our tissues and our bodies can’t handle the drastic changes. Long term, our bodies adapt to stresses and that presents as disease states like ASCVD, neurodegenerative diseases, metabolic dysfunction, and other problematic processes over the course of our lives.

I hope that answer is helpful in some way.

Also, it should be noted that exercise, like nicotine, is a drug and the dose needs to be correct. Healthy is a relative term and that needs to be taken into account as well.