Michael Hunter, MD on Medika Life

This Exercise Type May Be Best for Lowering Your Blood Pressure

Approximately one in three adults in the United States has high blood pressure (hypertension).

I JUST DID A TWO-HOUR GYM WORKOUT, including aerobic and resistance training activities. The first exercise form helps to keep my blood pressure low. Today, we look at new evidence that exercises engaging muscles without movement — such as wall squats and planks — may be best for lowering your blood pressure.

Approximately one in three adults in the United States has high blood pressure (hypertension). High blood pressure is like having a pipe with too much pressure, which can cause leaks and damage over time.

Many with hypertension don’t know that they have it. For this reason, some refer to high blood pressure as a “silent killer.” The condition can lead to heart attack and stroke, and there are usually no warning signs.

“Hypertension is a leading risk factor for death and disability worldwide,” says Dr. Paul Whelton, an expert in hypertension and kidney disease at Tulane University. “High blood pressure raises the risk of having a heart attack, heart failure, stroke, or kidney disease.”

Fortunately, we can often prevent or effectively manage high blood pressure. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health.

Before we jump into the new findings about exercise types and lowering blood pressure, here’s one of my favorite authors:

“Listening to the music while stretching her body close to its limit, she was able to attain a mysterious calm. She was simultaneously the torturer and the tortured, the forcer and the forced. This sense of inner-directed self-sufficiency was what she wanted most of all. It gave her deep solace.”
― Haruki Murakami, 1Q84

Today’s Exercise

I began my day with a 60-minute walk. After breakfast, my wife and I headed to the gym for a couple-hour workout. Here’s what we did in our “Push” program:

  1. Barbell bench press, four sets of 8
  2. Dumbell incline bench press, three sets of 12
  3. A superset of dumbbell include bench chest fly (3 x 12) + push-ups (3 x 10)
  4. Dumbell seated shoulder press, 4 x 8
  5. A superset of machine-assisted dips (4 x 10)
  6. Dumbbell overhead tricep extension (3 x 10)
  7. Cable straight bar tricep pushdown 3 x 15

We separated the sets by 30 seconds (except for supersets, in which the two exercises were followed by 30 seconds of rest before repeating the superset).

Next came an abdominal workout (including planks and more), with a treadmill walk and stretching to finish. I love being in the gym, surrounded by others working hard.

The downside? In two days, I will be sore. But a good kind of sore.

A man performs a plank, an isometric exercise. Adobe Stock Images.

Isometric (Static) Exercise

Before we turn to the study, I want to talk briefly about isometric exercises. These exercises can help you maintain strength (but you could be better at building it).

Isometric exercises are tightening (contractions) of a specific muscle or group of muscles. During isometric exercises, the muscle doesn’t noticeably change length. The affected joint also doesn’t move.

The Mayo Clinic offers that isometric (static) muscle action occurs when muscles contract but do not visibly change length. The involved joints do not move, facilitating body stability.

Isometric exercises can be done with weights or without, relying on the body’s weight.

I do isometric exercises in many places, including at home, work, the gym, and others. If you have ever done a plank, you have engaged in an isometric exercise.

At the end of this piece, I will provide examples of isometric exercises.

Exercise and Blood Pressure — A New Study

To understand two optimal exercises for lowering blood pressure, let’s look at recent study published in the British Journal of Sports Medicine.

Researchers examined 270 randomized clinical trials that reported the effects of exercise interventions. All lasted at least two weeks and measured blood pressure between 1990 and 2023.

Systolic blood pressure measures arterial maximum pressure as the heart contracts and relaxes, while diastolic blood pressure denotes what the arterial pressure is when the heart rests between beats, according to the US Centers for Disease Control and Prevention.

Best Two Exercises to Lower Your Blood Pressure

Here are the results of the meta-analysis of 270 trials with 15,827 participants.

Among HIIT, isometric, aerobic, dynamic resistance, and a combination of the latter two exercises, isometric exercise led to the greatest reductions in blood pressure.

More specifically, wall squats led to the biggest drop in systolic blood pressure. Running (aerobic exercise) was most beneficial for decreasing diastolic pressure. For lowering both systolic and diastolic pressure, isometric exercise was best.

Here are the findings in graphic form:

Meta-analyses have potential problems. Below is a reference outlining some of these issues:

https://drive.google.com/viewerng/viewer?url=https%3A//www.meta-analysis.com/downloads/criticismsofmeta-analysis.pdf&embedded=true

Isometric Exercise to Drop Blood Pressure — My Take

I am delighted you have many ways to exercise to lower your blood pressure. Find something you enjoy and be consistent.

Of course, I will continue to pursue other lifestyle interventions to benefit my blood pressure. This focus means I will continue to strive to keep a healthy weight, eat a balanced diet (including limiting my salt intake), not drink excessive alcohol, not smoke, and check my blood pressure regularly.

So far, I have dodged blood pressure medicines. I want to continue to do so.

Finally, I hope scientists will figure out why isometric exercises are better at lowering blood pressure than other physical activity forms. Let’s end with two of my go-to isometric exercise, with explanations from Healthline.com.

Isometric Exercises

Photo by Olivia Bauso on Unsplash

1. High plank hold. The high plank hold effectively engages many muscles. This exercise requires no equipment, although I prefer a yoga mat. High planks work your abdominals, glutes, quadriceps, arm muscles, shoulders, and chest. Here is what you need to do:

  • Begin with a kneeling push-up. Put your hands shoulder-distance apart.
  • Push your hands into the floor and straighten your knees. Push down into the balls of your feet to lift your body into a high plank position. You should appear as if you’re in the upward position of a push-up. Ensure your shoulders and hands are aligned, your legs straight, and your core engaged.
  • Hold the position for about 20 to 60 seconds (or as long as you can with proper form). Repeat two more times.

I’m not particularly eager to get all the way up (shoulder discomfort, alas), so I do the exercise with my lower arms on the mat.

2. Wall sit

I use wall sits to strengthen my thighs (quadriceps, hamstrings, and butt muscles). This activity helps me rehab from a torn right patellar tendon. Fortunately, no equipment is needed.

  1. Stand roughly two feet away from a sturdy wall, leaning against it.
  2. Bend your knees and lower your butt. Your knees should form a 90-degree angle. Your body position should look as if you are sitting in a chair.
  3. Hold the position for at least 15 seconds. Be sure to keep your hips and shoulders in contact with the wall. Also, keep your knees over your ankles. Don’t lower so much that you put too much pressure on your knees.
  4. Perform two or three rounds.

Trust me: Your thighs will get tighter and fatigued.

Optimizing Your Isometric Exercise

Here are some tips for you to get the most out of your isometric exercises:

  • Focus on good form. Watch your form to reduce your risk of injury and target your muscles effectively. Once you can’t perform the exercise with proper form, stop.
  • Actively contract your muscles. As you perform the exercise, notice your muscles contracting. This attention should help you maintain good form and better muscle activation.
  • Breathe. I have to remind myself to breathe during isometric exercises. Makes sure you breathe throughout the activity.
  • Please don’t overdo it. Overdoing can lead to injury. Instead, focus on proper form.

Finally, adjust the isometric exercise to your current fitness level. Is 20 seconds too long for your plank? Try ten. You should improve over time.

I will regularly incorporate isometric exercises into my exercise program while tracking my blood pressure. I hope to keep you posted on my anecdotal experience.

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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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