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Pilates

Posted by jris35 @jris35, Feb 23 10:05am

Do I need to have any legitimate concerns regarding Pilates? I am 64, with a 4.6 dilation in 2024, up from 4.0 in 2013. I am in reasonably good shape, avid runner (at conversational level) and Pilates once a week in a studio. I am now taking losartan to keep blood pressure low as well as cholesterol medication (this has been long-term. Numbers are good due to medication, but a recent calcium score of 665). It's never been above 130/85. My cardiologist said Pilates is fine, but I've read other things on the internet (ChatGPT, more concise than Doctor Google) which suggest caution. Any thoughts?

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moonboy | @moonboy | Feb 23 11:57am

I get why you're asking—there's a lot of conflicting info out there, and when it comes to aortic health, you don't want to take chances. I’m an aortic dissection survivor myself (Type A in 2015, emergency open-heart surgery, Dacron graft), so I take these concerns seriously.

Your cardiologist gave you the green light for Pilates, and that’s a good sign. Pilates is generally controlled and low impact, which is a plus for aortic health. The concern with any exercise is avoiding sudden spikes in blood pressure, excessive straining, or anything that puts too much pressure on the aorta. Since you’re already on losartan and keeping your numbers stable, your risk is lower—but not zero.

A couple of things to keep in mind. Watch for breath-holding (Valsalva maneuver)—it can cause blood pressure surges. Focus on steady, controlled breathing. No grunting, heaving, heavy weights, deadlifts, or planking. Be mindful of deep twists or loaded spinal flexion—some movements might put unnecessary stress on your core and indirectly affect aortic pressure. Listen to your body—if anything feels off, lightheaded, or strange, stop immediately.

Your calcium score of 665 means there's some coronary artery disease to factor in, but since your cholesterol is controlled and BP is good, that’s more about long-term monitoring than an immediate exercise restriction.

Bottom line? Pilates is likely fine with modifications. Since you’re in a supervised setting, let your instructor know about your aorta so they can help tailor movements. Keep an open line with your cardiologist and trust your instincts—your body will tell you if something isn't right.

Stay strong. Peace.

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1 reply
jris35 | @jris35 | Feb 23 5:44pm
In reply to @moonboy "I get why you're asking—there's a lot of conflicting info out there, and when it comes..." + (show)
@moonboy

I get why you're asking—there's a lot of conflicting info out there, and when it comes to aortic health, you don't want to take chances. I’m an aortic dissection survivor myself (Type A in 2015, emergency open-heart surgery, Dacron graft), so I take these concerns seriously.

Your cardiologist gave you the green light for Pilates, and that’s a good sign. Pilates is generally controlled and low impact, which is a plus for aortic health. The concern with any exercise is avoiding sudden spikes in blood pressure, excessive straining, or anything that puts too much pressure on the aorta. Since you’re already on losartan and keeping your numbers stable, your risk is lower—but not zero.

A couple of things to keep in mind. Watch for breath-holding (Valsalva maneuver)—it can cause blood pressure surges. Focus on steady, controlled breathing. No grunting, heaving, heavy weights, deadlifts, or planking. Be mindful of deep twists or loaded spinal flexion—some movements might put unnecessary stress on your core and indirectly affect aortic pressure. Listen to your body—if anything feels off, lightheaded, or strange, stop immediately.

Your calcium score of 665 means there's some coronary artery disease to factor in, but since your cholesterol is controlled and BP is good, that’s more about long-term monitoring than an immediate exercise restriction.

Bottom line? Pilates is likely fine with modifications. Since you’re in a supervised setting, let your instructor know about your aorta so they can help tailor movements. Keep an open line with your cardiologist and trust your instincts—your body will tell you if something isn't right.

Stay strong. Peace.

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Thank you. This is very helpful. Family history of heart disease -- grandfather, father and two brothers passed away before 55. So, I have always been focused on that issue, not a dilated aorta.

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