What is the best exercise to lower blood pressure?

Brisk walking, cycling, and swimming are exercises doctors recommend for controlling high blood pressure. However, a study (Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomized controlled trials) found that isometric exercises like planks and wall sits were more effective than these aerobic exercises in lowering blood pressure.

 

A research team at Canterbury Christchurch University in the UK examined clinical trial data on the effects of exercise training interventions lasting at least two weeks on resting blood pressure. The team analyzed the results by categorizing them into aerobic exercise, dynamic resistance exercise, and isometric exercise.

Healthy resting blood pressure is defined as less than 130/85 mmHg, prehypertension as 130-139/85-89 mmHg, and hypertension as 140/90 mmHg or higher. An analysis of 270 clinical trials involving over 16,000 participants between 1990 and 2023 found significant reductions in both systolic and diastolic blood pressure at rest after all different categories of exercise.

 

 

Isometric exercise has the greatest effect in lowering blood pressure.

 

In particular, isometric exercise showed the greatest decrease in systolic and diastolic blood pressure, with a decrease of 8.24/4 mmHg. The combination of aerobic and dynamic resistance exercise recorded a decrease of 6.04/2.54 mmHg, dynamic resistance exercise 4.55/3.04 mmHg, aerobic exercise 4.49/2.53 mmHg, and high-intensity interval training 4.08/2.50 mmHg.

 

Further analysis revealed that wall sit-ups were the most effective individual exercises for lowering blood pressure, while running was the most effective aerobic exercise. Isometric exercises involve muscle contraction without altering muscle length or movement. For example, pressing your palms together.

 

Representative isometric exercises include planks and wall sits. Wall sits are essentially squats performed against a wall. Exercises like planks and wall sits are readily available online and on YouTube.

 

 

Combining aerobic and strength training reduces the risk of high blood pressure.

 

Beyond these individual exercises, combining aerobic and strength training can significantly reduce the risk of high blood pressure. A combination of at least 150 minutes of aerobic exercise per week and at least one strength training session per week was found to have the greatest effect on lowering the risk of developing high blood pressure.

This is the result of a four-year follow-up analysis of data from the Korean Genome and Epidemiology Survey (KoGES) of 5,075 people in their 40s to 70s living in Ansan and Anseong, Gyeonggi Province, conducted by a team of postdoctoral researchers at the Department of Genomic Epidemiology, Future Medical Research Division, National Institute of Health, Korea Disease Control and Prevention Agency.

According to the results, aerobic exercise was associated with hypertension in terms of intensity, while strength training was associated with hypertension in terms of frequency. The exercise combination of moderate-intensity or higher aerobic exercise and strength training at least once a week was the most effective, reducing hypertension rates by 34% in men and 44% in women.

 

Moderate-intensity aerobic exercise alone, at least 150 minutes per week, showed consistent benefits, reducing the incidence of high blood pressure by 31% in men and 35% in women. However, adding strength training at least once a week reduced the risk of high blood pressure by an additional 35%.

 

Conversely, low-intensity aerobic exercise was ineffective, and strength training alone did not prevent hypertension. Moderate-intensity aerobic exercise is defined as at least 150 minutes per week, at an intensity that produces sweating or leaves you slightly out of breath but still able to hold a conversation with someone nearby.

This includes walking, brisk walking, hiking, and running. Strength training refers to resistance training that uses the weight of the body or equipment to increase muscle mass through repeated relaxation and contraction of the muscles.