Being an athlete does not make you immune to age.

As most endurance athletes do, I have to
supplement salt due to heavy sweating during
long workouts.

I've known for a very long time that there would eventually come a day when my blood pressure would rise, and stay risen, and, in all likelihood, require life long medication to control it.

I'm not a hundred percent certain that's where I'm at now, but I am now on a blood pressure medication, as I was for a short period of time in my 30s. Back then, it turned out to be this transient issue, that might have been due to stress, or a temporary reduction in my training regimen, or whatever it was at the time. If anything, I've grown to understand that medicine is not an exact science, but can sometimes be a series of trials guided by scientifically backed studies and principles. I will never know what the root cause of that temporary spike was in my 30s, but I do know that I've been predisposed to this sort of thing all my life.

Blood pressure tends to rise with age due to a number of factors, some of which can be controlled through "lifestyle changes" (ie. diet and exercise, and stress reduction), and others that cannot be avoided. Structural changes in the body essentially amount to increased artery stiffness which may or may not be associated with heart disease.

My blood pressure has consistently hovered around 130/80 to 140/90 since as far back as we could find medical records on me (back to age 7), when I first had to have this conversation with my doctor shortly after I got out of college. We decided to watch it, and about 10 years later, I wound up with my first round of BP driven higher by a number of factors--job stress was quite high at the time, and I was at a relative downturn in my athletic training. I was swimming and beginning to train for what would be the first marathon I completed, but I was in denial about that marathon--I thought I was calling Brian's bluff when he said he wanted to do one, and I half-heartedly went through the training plan and got to the start line--I walked the last 8 miles of that marathon.

During that time, I had a number of appointments with several cardiologists and a nephrologist.  It was when I discovered that I have a PFO with atrial septal aneurysm, which sounds a lot scarier than it actually is.  It's a flappy opening between the atrial chambers of my heart, and a weak wall that moves with every beat of my heart.  The combination of the two is considered not common (2-3% of the population is estimated to have that, while the PFO by itself is probably present in 20% of the population).  Long story short--I had to have a TEE (trans-esophogeal echocardiagram) to diagnose the thing, and I do not recommend this procedure to anyone--having an echo machine shoved down your throat while you're conscious and being told to move around and strain your abdomen is not a fun way to spend an afternoon. I carry an increased risk for stroke because of this, and take daily aspirin to reduce that risk.

In any case, I thought my blood pressure was related to this structure, until I was told otherwise--kidneys control your blood pressure, not this structural heart abnormality.  I went on blood pressure meds--at first a diuretic, and was told to limit my salt intake, and watch my diet, and do all the things cardiologists are trained to tell their patients that they assume are sedentary and don't sweat out all that salt all the time.  I cramped up and become unable to train, and I would sweat profusely under the easiest of workouts, and then cramp up some more.  I came to the conclusion that a drug that left me unable to exercise was probably going to have worse consequences in the long term than what it was treating me for.  My first cardiologist suffered from a bit of a god complex--I couldn't get a word in edgewise to ask about details like this, so I left him and went elsewhere.  I wound up on a drug called Atacand, which worked for a while, and then overdid its job, and my doctor cut down the dosage, and then cut it down some more, and then some more.  I eventually came off of it, and my blood pressure stayed in the normal zone for me.

My guess is that the way my first cardiologist treated me is not uncommon--a very common issue that causes BP increases in people as they age is an imbalance in electrolytic salts that increases BP, and a diuretic is appropriate in these cases. They see a guy in his 30's, assume that's what it is, and write it off as an everyday common occurrence. It also turns out that sweating 5 or 6 days out of the week does the same thing, and combining the two can be disastrous. At the time, maybe my temporary increase in BP was due to a salt issue--I was on the upswing of a training plan that turned into the very active triathlete lifestyle that I have now. Maybe it wasn't--I won't ever know for sure. What I do know is that exercise can help to ward off blood pressure increases because of salt issues, but it doesn't make you immune to other causes.

I got a good reading the other day
Hopefully, it will stabilize there!

Increasing inflexibility of the arteries is something that happens with age--in some people, it's later in life than others. Ignoring it is the biggest problem, because increases in blood pressure are associated with significant medical events (heart attack, stroke, kidney damage to name a few). You are not immune to this just because you work out all the time.  So, if you're not having physicals on a regular basis, get on that. And if you're not seeing a doctor you can have conversations with about all of these things, find another one.

Exercise can (and does) help. It's just that it's not a guaranteed cure--in my case, it probably staved off the inevitable for a good 20 years or so. Maybe I'll need to stay on this drug for the long term, or maybe I'll have a similar reduction over time like I did in my 30s...I'll work with my doc on that one.

Stay healthy, and live long!