New research challenges the conventional belief that aerobic or cardio exercises are the best for lowering blood pressure. According to a large study published in the British Journal of Sports Medicine, exercises involving isometric or static muscle action, such as wall squats and planks, may be more effective in preventing and treating hypertension. Isometric exercises engage muscles without movement, promoting body stability as muscles contract without visibly changing length and without joint movement, as described by the Mayo Clinic. Including these exercises in blood pressure management routines could prove to be a valuable addition.
Isometric exercises can be performed with or without weights, making use of the body’s own weight for resistance. According to a news release from Dr. Jamie O’Driscoll, a coauthor of the study and a reader in cardiovascular physiology at Canterbury Christ Church University’s School of Psychology and Life Sciences in England, isometric exercise training stands out as the most effective method for reducing both systolic and diastolic blood pressure.
The results of this study offer a comprehensive, data-driven framework that can serve as a basis for the development of updated exercise guidelines aimed at preventing and treating arterial hypertension.
The current guidelines for managing blood pressure through exercise predominantly focus on aerobic or cardio activities like running or cycling. However, these guidelines are rooted in older research and fail to consider newer exercise protocols like high-intensity interval training and isometric training, which have shown promise in blood pressure management, according to the authors.
Recognizing the need for updated recommendations, the researchers conducted a review of randomized controlled trials involving exercise interventions lasting two weeks or more and conducted between 1990 and February 2023. The trials assessed the effects of these interventions on systolic and/or diastolic blood pressure.
For clarification, systolic blood pressure refers to the maximum arterial pressure during heart contraction and relaxation, while diastolic blood pressure represents arterial pressure when the heart rests between beats, as defined by the US Centers for Disease Control and Prevention.
In this study, the authors provided clear definitions for different blood pressure categories. They considered blood pressure below 130/85 mmHg as indicative of healthy resting levels. Pre-high blood pressure was defined as falling within the range of 130/85 mmHg to 139/89 mmHg, while high blood pressure was categorized as 140/90 mmHg or higher. It’s worth noting that the top numbers in these readings represent systolic pressure, while the bottom numbers indicate diastolic pressure.
Through a comprehensive meta-analysis of 270 trials involving 15,827 participants, the authors identified the varying effects of different exercise modalities on blood pressure. Among the exercise types studied, isometric exercise emerged as the most effective in reducing blood pressure.
According to the analysis, the reductions in blood pressure were as follows: 4.49/2.53 mmHg after aerobic exercise training, 4.55/3.04 mmHg after dynamic resistance training, 6.04/2.54 mmHg after combined training, 4.08/2.50 mmHg after high-intensity interval training (HIIT), and 8.24/4 mmHg after isometric exercise training.
Interestingly, wall squats, which are a form of isometric exercise, showed the most significant impact on reducing systolic pressure. On the other hand, aerobic exercise, such as running, demonstrated the greatest benefits in lowering diastolic pressure. However, when considering overall effectiveness in reducing both pressure elements, isometric exercise stood out as the best option.
“It’s encouraging to see other forms of exercise being explored in this research, as we know that individuals are more likely to sustain exercise they enjoy, which plays a crucial role in maintaining lower blood pressure,” stated Joanne Whitmore, senior cardiac nurse at the British Heart Foundation, via email. Whitmore, who was not involved in the study, shared her perspective on the findings.
“However, it’s important to acknowledge that lifestyle changes beyond exercise can also positively impact blood pressure,” she added. “These include maintaining a healthy weight, following a balanced diet, reducing salt intake, moderating alcohol consumption, and adhering to prescribed medications.”
The authors pointed out that further research is required to precisely determine why isometric exercises may be more effective in lowering blood pressure compared to other types of training.