By: Geisinger, interventional cardiologist, Sandy Green, MD

Exercises to combat high blood pressure
New evidence points to wall sits, planks and other isometric exercises as the most effective at lowering high blood pressure.

Movement is the key to combating hypertension, right? Not so fast.

It’s long been thought that aerobic exercise — think brisk walking, running and cycling — strengthens your heart and reduces blood pressure. And that’s true. But new evidence shows wall sits, planks and other isometric or static exercises are more effective at lowering high blood pressure.

While research shows all forms of exercise are good for your heart, isometric training is a promising exercise mode for people with high blood pressure. The good news is isometric exercises also bolster joint stability, promote better posture and can be beneficial for preventing injuries and aiding in rehabilitation.

What is isometric exercise?

Isometric exercise is a low-intensity form of strength training where you contract or tighten a muscle group and then hold still — without any joint movement.

While holding in a static position, the exercise relies on your body’s weight to help maintain strength and stabilize your joints and core.

Isometric exercise is convenient, can be done in just a few minutes and doesn’t require any equipment and you can perform it easily at home or in the office during breaks.

Why are isometric holds the best exercise to lower blood pressure?

A study published in the fall of 2023 in the British Journal of Sports Medicine revealed that while most types of exercise helped lower blood pressure, isometric training was the most effective at lowering both systolic and diastolic blood pressure — especially in people with high blood pressure.

When doing a plank or other isometric hold, your muscles contract and generate tension. That makes your blood vessels constrict, causing more demand for oxygen and nutrients. Decreased blood flow stimulates the production of nitric oxide, which dilates blood vessels to improve blood flow and supply these required resources. As a result, more blood can flow through the blood vessels and blood pressure is reduced.

Strength training also engages the muscles and constricts blood vessels, but not for an extended time. When you do a bicep curl, you don’t hold it for several minutes. You lift it quickly and go back down, so you’re not getting the decreased blood flow to the area and increased production of nitric oxide from holding the position.

An isometric hold also increases your heart rate and cardiac output to supply more oxygen to your muscles. Over time, this strengthens and conditions your heart to pump blood more efficiently and reduces stress on blood vessels, leading to lower blood pressure.

What are isometric exercise examples?

While all isometric exercises can contribute to lowering blood pressure, some are more effective than others. In the study, researchers studied three isometric exercise examples in particular: squeezing a handgrip, leg extensions and wall sits, also called wall squats. The wall sits were found to be the most effective isometric exercise of them all.

To do a wall sit, position yourself with your back against a wall and slide down until your knees are bent at a 90-degree angle. Hold this position for 20 seconds or more. The wall sit primarily focuses on your quadriceps and glutes. The optimal isometric exercises for lowering blood pressure are those that engage multiple muscle groups and increase your heart rate.

The study found doing four sets of two minutes each with a rest period in between, three to four days a week, yields maximum benefits. Other isometric exercise examples include:

• Plank, side plank and reverse plank
• Glute bridge
• Dead hang from a pull-up bar
• Static lunge
• V-sit
• Standing wall push-ups
• Calf raise and hold
• Tricep dip and hold
• Bicep curl and hold
• Overhead hold
• Kettle ball hold in front of you

When doing any isometric hold, breathe slowly and regularly to make sure your muscles get plenty of oxygen. You can start by holding the position for 20 seconds and slowly working your way up to holding it for two minutes. Just be sure to talk with your doctor before starting any new exercise routine.

Adding isometric holds as “exercise snacks”

There is increasing evidence that points to the health benefits of “exercise snacks,” short bursts of vigorous activity spread throughout the day. If you struggle to find 30 minutes to work out each day, these two-minute or so “snacks” can quickly add up to help you meet your daily fitness goals.

Incorporating exercise snacks into your daily routine is a great way to vary your workouts. For office workers, this is an easy way to get in exercise snacks throughout the day and positively impact blood pressure.

So do wall sits between phone calls, hold a plank if you’ve been sitting too long or grip a stress ball before heading to a meeting.

It breaks up your day at the office and can get you up and out of your chair even if you do it three or four times a week, that’s enough to lower blood pressure. Small changes can make a big difference.

Adding isometric exercises doesn’t mean you should stop doing all other types of exercise, like strength training and cardiovascular workouts. It’s important to include all forms of exercise for your overall health and heart health.

The American Heart Association recommends 150 minutes of moderate-intensity exercise (hiking, biking, water aerobics) or 75 minutes of vigorous aerobic activity (running, swimming laps) each week.

Research is well established that aerobic training is just as important as strength training, which is just as important as stretching and isometric exercise for longevity. Each type of exercise plays a vital role in building the body’s strength, endurance, coordination, flexibility and functionality.

For the latest health and wellness tips and advice, visit geisinger.org/balance.