TAA and exercise

Your question hits on something that confused me too. On the one hand, you’re told to keep your blood pressure as low as functionally possible (which is good advice), but then you hear “no restrictions” on cardio, even though cardio raises BP—so it feels contradictory.

Here’s how I made sense of it: the concern isn’t that your blood pressure goes up temporarily during controlled, rhythmic exercise like a Peloton ride—it’s the spikes from things like straining, heavy lifting, or sudden stress that are more dangerous. Those can create abrupt pressure changes in the aorta wall. Steady-state cardio raises BP in a more gradual, controlled way, and your body is prepared for it.

But still—everyone’s anatomy and risk profile is different. At 4 cm, you’re still below most surgical thresholds, but you’re right to ask questions. I personally opted for more conservative workouts after my dissection: brisk walks, elliptical, yoga (without deep twists or breath holds). I also check my BP before, during, and after anything new. I’m a 10 year survivor of a dissection currently at 4.2 cm.

Bottom line—trust your gut and ask follow-up questions. No one will advocate for you like you will. Peace.

@moonboy has covered pretty much the bootom line, there are exercies that punctually may raise your BP to dangerous high levels (dangerous for someone with an aneuryms or prone to having them), anything that makes you hold yor breath or grunt (lifting heavy weights, crunches for most people, etc) will raise your BP to significant levels for a very short period of time. On the other hand, keeping yourself in good shape will pay dividend when and if you ever need surgery, right now you are very far from the critical zone (as it approaches 5.0) and depending on growth rate you may never need surgery. I had my surgery 5 years ago at 5.2cm, I was in very good physica shape and my surgeon gave me >99% probability of no complications. Open Heart surgery is tough but for me it was as easy as it coud have been, recovery was very fast too.

I had very few limitations regarding cardio exercise, but my cardiologist was very emphatic regarding strength training.

Here is a video I have posted many times when this question has been asked, it is an interview with a cardiologist who is an aortic disease expert regarding the exercise subjet, hope it helps. All the best to you!!!

Great comments! Have not looked at the video but I will.
Have not heard anything definitive about this subject but my question is- Does it matter how long the increase in BP lasts that is the main risk, or does any increase over a certain level present a risk to the condition of the aneurysm?
Mine is 3.9 cm and have not changed over several years. My normal BP is in the 115/65 range (I am on meds) and recently tested it right after a rigorous set of push ups. It went up to 175/80 but came back down pretty fast.
Any thoughts will be appreciated. Thanks