Want to reduce your blood pressure? Do wall squats!

If you go to your doctor and the diagnosis is high blood pressure, the chances are that your doctor will recommend aerobic (’cardio’) exercise, such as walking, running, and cycling, perhaps even yoga and lifting weights, as the best means for managing blood pressure

But, says a new research study, these recommendation are largely based on older data that exclude newer forms of exercise, such as HIIT and isometric exercise, meaning that they’re probably outdated

In a review of 270 clinical trials, involving 15,827 participants between 1990 and February 2023, published in the British Medical Journal, Dr Jamie O’Driscoll, a researcher in cardiovascular physiology at Canterbury Christ Church University, describes how isometric moves, such as a plank or a wall sit, could be helpful not only for the 14 million people in the UK who already have hypertension but everyone of middle-age and older

“When people think about resistance exercise they assume it involves a lot of dynamic movement such as repetitive weightlifting or lunges and squats,” O’Driscoll says. “Isometric exercise is overlooked but is something we should all be adding to the mix”

Rather than performing endless repetitions with increasingly heavy weights, eight minutes of isometric exercises – such as planks, wall sits and squat holds – three times a week could bring benefits for heart health while boosting balance, posture and muscular endurance

In a bid to update information on the best form of exercise for controlling blood pressure, O’Driscoll’s team trawled research databases looking for clinical trials reporting the effects of an exercise training intervention lasting 2 or more weeks on resting blood pressure

The exercise interventions were classified as aerobic (‘cardio’); dynamic resistance training; a combination of these; HIIT; and isometric exercises

Healthy resting blood pressure was defined as a reading below 130/85 mmHg; pre-high blood pressure as 130–139/85–89 mmHg; and high blood pressure as 140/90 mmHg or more

Systolic blood pressure, the first number in a reading, measures arterial pressure when the heart beats; diastolic blood pressure, the second number, measures arterial pressure between beats

The pooled data analysis showed significant reductions in resting systolic and diastolic blood pressure after all the various categories of exercise, but with the largest falls in both systolic and diastolic blood pressure after isometric exercise training

The reductions in blood pressure after aerobic exercise training amounted to 4.49/ 2.53 mmHg; 4.55/3.04 mm Hg after dynamic resistance training; 6.04/2.54 mmHg after combined training; 4.08/2.50 mmHg after HIIT; and 8.24/4 mmHg after isometric exercise training

The rank order of effectiveness values for reducing systolic blood pressure was isometric exercise training (98%), combined training (76%), dynamic resistance training (46%), aerobic exercise training (40.5%) and HIIT (39%)

Secondary analyses revealed wall squats (isometric) and running (aerobic) as the most effective individual exercises for reducing systolic blood pressure (90.5%) and diastolic blood pressure (91%), respectively, with isometric exercise, overall, the most effective for reducing both blood pressure elements

While results showed that all exercise was helpful in reducing hypertension, it’s clear that static exercise was the most effective. “When you work a muscle isometrically by holding it under tension with no movement, blood vessels compress,” O’Driscoll says. “When you release the hold there is a sudden increase in blood flow as the blood vessels dilate again, which is an effect you don’t get in the same way with other forms of exercise”

O’Driscoll acknowledges that variations in the types of participants included across the clinical trials and differences in statistical and methodological processes and exercise interventions may have influenced the findings, and so should be interpreted in light of these limitations

But he concludes, nevertheless: “Overall, isometric exercise training is the most effective mode in reducing both systolic and diastolic blood pressure. These findings provide a comprehensive data-driven framework to support the development of new exercise guideline recommendations for the prevention and treatment of arterial hypertension”

Perhpas the best solution is to add isometric exercises to your current routine. The real beauty of static training is that it requires little or no equipment – you can do it using your own body weight – and it is supremely time efficient. If you can, do your isometric moves at the end of a workout to maximise gains in muscle endurance. But you can get great health gains from doing just a few minutes on a regular basis standalone

Choose any four of plank, bear plank, V-sit, squat hold, wall sit and bridge to hold for two minutes each – a total of eight minutes a workout – with two minutes’ rest in between. Feel the benefit!