Planks and wall sits best for lowering blood pressure, study finds

Static isometric exercises – the sort that involve engaging muscles without movement, such as wall sits and planks – are best for lowering blood pressure, according to a study published by the British Journal of Sports Medicine.

The researchers, who reviewed evidence from clinical trials, claim the evidence suggests it may be time to review current exercise guidelines for the prevention and treatment of high blood pressure.

Previously published research shows that exercise in general is associated with significant reductions in blood pressure, with aerobic or “cardio” exercise, such as walking, running and cycling, primarily recommended.

But the authors of the new analysis say the recommendation for aerobic exercise is largely based on older data that exclude newer forms of exercise such as “high-intensity interval training” (HIIT) and isometric exercise. They suggest that the current recommendations are probably outdated.

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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.

In all, 270 randomised controlled trials published between 1990 and last February were included in the final analysis, with a pooled data sample size of 15,827 participants. The 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.

Analysis revealed wall squats (isometric) and running (aerobic) as the most effective individual exercises for reducing systolic blood pressure and diastolic blood pressure respectively. Overall, isometric exercise was the most effective for reducing both blood pressure elements.

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“Overall, isometric exercise training is the most effective mode in reducing both systolic and diastolic blood pressure,” the researchers say. “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.”

However, Dr Ray Walley, a GP and former president of the Irish Medical Organisation, said the “important message” was that exercise is good for human health.

During isometric exercises, the muscle does not noticeably change length and the affected joint also does not move, but Dr Walley said it was well known that the use of “small weights” also helps to build musculature – the “scaffolding” which supports the bones.

“It reduces the chance of osteoporosis, helps with blood pressure and increases tone in muscles,” he said.