As somebody who suffered a complete aortic dissection in 2015 and barely managed to survive it, here's my advice: no heavy lifting, battle ropes, grunting, planking, straining, snowblowing, or operating anything with a pull start engine. Get your BP down and under control right now. Frankly, I wouldn't take advice from anyone except someone who survived a dissection or a cardiothoracic surgeon who is an expert in aortic repair. Aortic measurements can vary by a few millimeters depending on the type of imaging that you use and who is using it. That said, once you get to 5 cm, it's time to get cracking and schedule that surgery. Trust me when I say this: you do not want to suddenly dissect because you will likely not survive it. Having a planned surgery is like getting a tire repaired at a fully staffed and stocked tire shop at 8:00 a.m. on Monday morning. A sudden dissection is like trying to change a tire on Friday afternoon, in the middle of a busy freeway, in 112F heat. Doubt me? Ask a thoracic surgeon who has been paged in for one of these at 3:06 a.m. Peace.