By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.

The traditional recommendation for exercise programs in people with hypertension is to do aerobic exercise for 30 to 45 minutes on at least three days a week. The effects of resistance (isometric) exercise on resting blood pressure have not been extensively investigated. The analysis described here examined the medical literature for studies in which the effects of a resistance exercise program on resting blood pressure were examined, by comparing the changes in an exercise group with a sedentary control group. Eleven such studies were found, most of which were carried out in people with normal blood pressure. The average length of training was 14 weeks, with three sessions of 40 minutes a week. The participants performed an average of 10 different muscle-strengthening exercises, with about 20 repetitions of each exercise.

The main finding of the analysis was that the average blood pressure decrease in the exercise groups was 3/3 (systolic/diastolic) mmHg more than the changes in the control group. Heart rate was not affected. Body weight did not change, but there was a decrease of body fat, which was matched by an increase of lean body mass.

Doctor’s comments

This analysis suggests that resistance exercise (muscle strengthening) training - sometimes known as circuit training - has a small but beneficial effect on the resting blood pressure. The studies did not include enough people with high blood pressure to be able to say whether the changes would be the same in them, but they would probably be at least as large. Sustained muscle contraction can produce a very large increase of both systolic and diastolic pressure, but the types of exercise described in these studies usually involved repetitions of relatively short duration, which should not be of concern.

The bottom line is that while resistance exercise appears to be beneficial for blood pressure, aerobic exercise is still preferable for people with hypertension, in whom weight control is often a factor.

Where it was published