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New research suggests that isometric exercises, such as wall sits, are most effective at lowering blood pressure. LeoPatrizi/Getty Images
  • A new analysis of 270 studies investigated the benefits of various forms of exercise in lowering blood pressure and found that static isometric exercises are the most effective.
  • All of the forms of exercise included in the analysis provided benefits, though less so than isometric exercises, such as wall sits.
  • Experts say that a mix of different forms of exercise provides the strongest overall health benefits.

Exercise is associated with better health. And according to a new study, isometric exercises may be best for people with high blood pressure, also known as hypertension.

The study authors compared aerobic, dynamic resistance, combined, high intensity interval (HIIT), and isometric exercise methods and the effects of each on blood pressure.

While all these exercise types effectively lowered blood pressure, one form, in particular, stood out.

Based on the findings, isometric exercise training had the most significant impact on lowering blood pressure.

Isometric exercises were followed by combined training, dynamic resistance training, aerobic exercise training, and HIIT.

The researchers performed a large-scale systematic review and analysis of 270 randomized, controlled exercise trials aimed at identifying the most effective workout type for managing high blood pressure.

All the trials considered in the review featured exercise interventions lasting at least 2 weeks or longer. A total of 15,827 participants were included in the review.

The study is published in the British Journal of Sports Medicine.

Isometric exercise involves increasing tension in a muscle without moving any surrounding joints.

This is achieved by pushing against something immovable that provides resistance, such as a wall, a companion, or a device, or simply holding a position where a muscle remains tense, such as in isometric weightlifting.

According to the new research findings, the most effective isometric exercise for lowering resting blood pressure was wall sits, said study co-author Dr. Jamie O’Driscoll, a registered clinical scientist in cardiology.

Wall sits involve slowly descending to a squat as you press your back against a wall, holding it to apply tension to the involved muscles, and coming back up.

Isometric exercise is also called “static” exercise because there is no movement involved, just pressure being applied by the relevant muscle.

Other examples of isometric exercise include:

  • planks and side planks
  • calf raises and holds
  • low squat holds
  • overhead holds
  • v-sits
  • glute bridges

Dr. Yu Ming Ni, a cardiologist with California Heart Associates in Fountain Valley, CA, who was not involved in the study, explained to Medical News Today:

“The idea is that isometric exercise builds muscle mass. In theory, it’s supposed to train the blood vessels to have improved basal dilation.” In that sense, it may work to lower blood pressure.

Of course, it’s a good idea to always consult your physician before beginning a new exercise regimen.

Dr. Melody Ding, PhD, associate professor at the Sydney School of Public Health, also not involved in the study, said she found the study convincing.

“The authors used a strong research design and the analysis was well-done,” Dr. Ding told MNT.

Dr. Ni, on the other hand, was cautious. He said the study “turns on its head the previous notion of what’s considered to be blood pressure-lowering exercise.”

“I would think that dynamic exercise is more important, but this study definitely seems to suggest the opposite. You’re literally increasing the pressure in your body to do this. I don’t know if that’s really quite the best mechanism for that.”

— Dr. Yu Ming Ni, cardiologist

Dr. Ni added there was no large difference between blood pressure outcomes and various forms of exercise.

“It does seem to trend for both systolic and diastolic blood pressure. So, I think it’s interesting, and it certainly gives me food for thought,” Dr. Ni said.

Dr. O’Driscoll told MNT: “Our research has not shown any unique adverse effects compared to other forms of exercise.”

Nonetheless, isometric training — or any exercise — should be cautiously prescribed, said Dr. Ni, by patients whose blood pressure is dangerously high at the outset.

For example, Dr. Ni said he has patients who are bodybuilders and also have high blood pressure. He wouldn’t recommend weight training for these individuals if their blood pressure spikes.

“[For] those patients, I would say ‘no, this is a bad idea. You can do dynamic exercise for now. Let’s get your blood pressure under better control, get you on some medications, review your salt intake, review your alcohol intake, and make sure you’re not using anabolic steroids,’” Dr. Ni explained.

Dr. O’Driscoll said that while “the results of this work demonstrate the value of performing static exercise for managing blood pressure, it is important to consider isometric exercise as complementary to pre-existing exercise modes, providing participants with a range of exercise choices rather than limiting them.”

Dr. Ding agreed, noting that “different types of exercise offer different health benefits. This study demonstrated that all these types of exercise studied offered a significant reduction in blood pressure, but they all offer other unique benefits too.”

Specifically, Dr. Ding noted that HIIT and aerobic exercises help strengthen cardiovascular fitness and muscle strengthening helps improve and maintain musculature.

Regardless of the form of exercise, however, most experts would agree that some exercise is better than no exercise at all.

“Stick to the exercise [you] enjoy — otherwise it is hard to maintain the habit — and second, incorporate various types of exercise to improve different aspects of health and fitness,” Dr. Ding concluded.