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Lauren Davenport, Senior Physiologist

How does exercise help lower blood pressure?

2 January 2025

28% of adults in the UK have been diagnosed with high blood pressure, also known as hypertension, with an estimated 11-14% living with it, untreated.1

High blood pressure causes our cardiovascular system to work harder. This extra strain can put pressure not only on our heart and blood vessels, but other organs like our kidneys which can increase our risk of heart attack, stroke, and kidney disease.2

So, what can we do to help lower it?

One of the most effective ways to lower blood pressure, through lifestyle behaviours, is with consistent physical activity or exercise.

This might feel daunting if you have recently been diagnosed with hypertension but rest assured that exercise is safe unless your hypertension is uncontrolled. So, if your doctor says it is safe, you should try to undertake regular activity in order to help manage your blood pressure.

How much exercise should I be doing?

If you have been diagnosed with high blood pressure, 30-60 minutes per day and at least 150 minutes per week of moderate intensity activity is recommended, as well as dynamic resistance training on 2-3 days of the week.3

Whilst aerobic activities have primarily been the focus for reducing blood pressure in those with hypertension, if you have a good level of fitness and have checked with your doctor, high intensity interval training (HIIT) can also be a way to reduce blood pressure, and those guidelines are 75 minutes per week.

How do I know what intensity I am exercising at? 

There are two easy ways you can gauge how hard your body is working, which is useful to know so that you can get the most benefit from your workout.

1) If you can talk, but not sing, this means you are likely in the moderate intensity zone, but if you can only say a few words before needing to take a breath, it’s likely you're at a high intensity. This is known as the talk test.4

2) Another way to gauge your intensity is using Rating of Perceived Exertion (RPE). The RPE scale is a clinically valid self-assessment tool used to measure your effort, exertion and fatigue, however if you are new to the scale or exercise, it might take a bit of practice.

You should rate how hard you feel like you are working on a scale of 1-10, with 1 being very light work (for example, sitting watching TV), and 10 being maximum effort (so you would not be able to go any harder). For moderate intensity, you should aim for a rating between 4-6, and 7-8 for high intensity.5

How does exercise lower my blood pressure?

An average blood pressure reading should be between 90/60 mmHg and 120/80 mmHg. Those with hypertension consistently have readings over 140/90 mmHg or higher.

When we exercise, we increase blood flow and stress on our vascular system, so our body adapts over time by increasing the blood vessel's ability to deal with that stress, hence lowering our resting blood pressure.6

What’s the best exercise for lowering blood pressure?

Aerobic exercise is the primary recommended form of exercise for hypertension, due to the vast amount of past research showing its reduction benefits for both systolic and diastolic blood pressure.

For example, one study analysed the lowering effect of aerobic activity in 27 randomised control studies, on individuals with hypertension. It showed that regular medium-to-high-intensity aerobic activity reduced blood pressure by a mean of 11/5 mmHg.7

However, more recent data is showing that other forms of activity are also, if not more, beneficial.

A 2023 systematic review showed:

  • aerobic exercise,
  • dynamic resistance training,
  • combined training,
  • high-intensity interval training
  • and isometric exercise training (exercises where your muscles are contracted whilst held in one position), were all significantly effective in reducing resting systolic and diastolic blood pressure.

Overall, isometric exercise training was found to be the most effective, followed by combined training (aerobic and resistance), resistance training, aerobic exercise, and HIIT.

Interestingly, walking was less effective than cycling or running, but the most effective form of exercise was wall sits.8

However, it’s important to remember that this doesn’t automatically disregard the current guidelines and the use of aerobic activity for blood pressure reduction, as there is still less data on these other forms of activity, and all studies have their limitations.9

If you already have a preferred exercise or routine that you enjoy, stick to this, as consistency is always most effective. If you are new to exercise or have low fitness levels, make sure to start slow, listen to your body, and build up gradually from there.

Exercises to try

Always remember to consult your doctor before attempting any new activity if you are unsure if it is safe for you, and don’t forget to include a warm and cool down.

1) Brisk walking

Add in some short inclines to get your heart rate up and moderately out of breath. Keep it interesting by varying your route.

2) Cycling, running or swimming

Try to keep your heart rate up by increasing your speed, using an incline, or changing up your stroke.

3) Gym classes

These can be great if you are new to exercise and unsure what to do. A circuit for example will even combine cardio and resistance training.

4) Isometric home workout

Isometric exercises are any exercise where your muscles are contracted whilst held in one position. Choose 4 or 5 holds and try to hold each one for 1 minute, for example, plank, squat hold, hip thrust hold, push up hold, and a wall sit.

No equipment needed and you can do as many rounds as you like but remember to rest between each round.

5) Yoga or Pilates

These can combine isometric holds, resistance, and aerobic training. As you get better, you can add in more resistance or complex moves to keep it interesting.

References

  1. Blood Pressure – NHS England Digital
  2. How to lower blood pressure – BHF
  3. ACSM’s Guidelines for Exercise Testing and Prescription, 11th edition (2021)
  4. Physical activity guidelines for adults aged 19 to 64 – NHS
  5. Borg Rating of Perceived Exertion (RPE) scale – Oxford Academic
  6. Pathophysiological mechanisms underlying the beneficial effects of physical activity in hypertension – National Library of Medicine
  7. Physical activity and exercise lower blood pressure in individuals with hypertension – National Library of Medicine
  8. Exercise training and resting blood pressure – British Journal of Sports Medicine
  9. Can wall squats and planks lower your blood pressure? – BHF



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