Lower your blood pressure without drugs — or even much movement: why a simple exercise may help

If I told you that one of the most effective ways to lower blood pressure involved hardly moving at all, you might assume the point of exercise had been missed entirely.

But an expanding body of evidence suggests that some of the best blood-pressure-lowering workouts are the ones that keep you nearly still.

As an A&E doctor, I regularly see the devastating effects of high blood pressure, from heart attacks to strokes.

For years, the usual medical advice has focused on tablets and lifestyle changes such as losing weight, cutting back on salt and taking exercise like walking or running.

Now, research published in BMJ Open Sport & Exercise Medicine points to a strikingly different way to bring blood pressure down.

In a study from Canterbury Christ Church University in Kent, adults with normal or mildly raised blood pressure were asked to perform a wall sit three times a week for four weeks. This means holding a seated position against a wall as though resting on an invisible chair.

Each session consisted of four two-minute wall sits, with two minutes of rest between them. In total, that added up to just eight minutes of actual exercise.

The results were impressive. After four weeks, the wall-sit group had an average 9.5mmHg reduction in systolic blood pressure, while diastolic pressure fell by about 5.5mmHg, compared with participants who did not do the exercise.

Those are meaningful changes when you consider that a standard dose of a single blood-pressure medicine lowers readings by an average of 9mmHg and 5mmHg respectively.

The researchers then examined what happened when participants either continued the wall-sit routine for another four weeks or stopped altogether.

Those who kept going retained the biggest benefits, and even doing the exercise just once a week helped preserve lower blood pressure.

By contrast, those who stopped saw their blood pressure drift back toward its previous level.

So what explains this? During wall sits, the muscles contract without movement, which is known as isometric exercise.

Most everyday exercise involves muscles shortening and lengthening as we move. With isometric exercise, the muscles still work hard, but they stay in roughly the same position because they are resisting gravity.

This is not the first time research has suggested that this form of exercise can reduce blood pressure.

In a major 2023 analysis in the British Journal of Sports Medicine that pooled 270 trials, isometric exercise including wall sits, handgrip squeezing and holding the legs still against resistance lowered systolic blood pressure by more than 8mmHg.

That was nearly twice the reduction seen with conventional aerobic activity such as running or cycling.

This newer study goes a step further by showing not only how quickly blood pressure can improve, but also how little exercise may be needed to maintain the benefit.

Other isometric exercises may help too, including standing and pushing against a wall, holding a plank, lying on your back with your legs raised, holding weights without moving them, or even hanging from a bar.

In each case, the muscles are working hard even though the body is not moving.

What makes these findings especially surprising is that isometric exercise raises blood pressure while you are doing it, even though it lowers blood pressure over time.

When you hold a wall sit or carry a heavy shopping bag, the muscles contract and squeeze the small blood vessels running through them, making it harder for blood to flow.

At the same time, because the muscles are working hard, they need more oxygen and send signals to the brain through substances such as lactate that stimulate nerve endings.

The body responds by activating the sympathetic nervous system — the same system involved in the fight-or-flight response — which makes the heart pump faster and increases blood pressure.

When you relax, the pressure on those small blood vessels is released and blood rushes back through them.

This prompts the vessel lining to release compounds such as nitric oxide, which widen the vessels.

As the muscles relax and the immediate stress response subsides, blood pressure falls. Repeating this process appears to help blood vessels relax more efficiently and improves the body’s control of blood pressure.

So although your blood pressure rises during the exercise, over time it can become lower.

There is a similar pattern with another increasingly popular health habit: cold showers or cold-water immersion.

When you first step into very cold water, the body reacts with a sudden physical stress.

Breathing speeds up, blood vessels in the skin narrow and the nervous system releases stress-related chemicals, especially noradrenaline, to help the body respond.

Blood pressure can rise as part of that reaction, which is one reason sudden cold-water exposure is not necessarily safe for people with heart problems.

But studies have shown that repeated exposure to cold water can make some of those immediate reactions less intense, including reducing the release of stress-related chemicals.

In a review published last year in PLoS One, researchers found that people exposed to cold water reported significantly lower stress levels 12 hours later.

Our bodies are remarkably adaptable. What first creates a strong response can, with repetition, lead to important and beneficial changes.

In the case of isometric exercise, we now have evidence that it can lower blood pressure.

And the encouraging part is that the amount of exercise required is not especially time-consuming.

If wall sits are not for you, other isometric moves can still help, such as holding weights with your arms stretched out in front or squeezing a handgrip for a few minutes. Begin slowly.

There is, however, an important warning. Because isometric exercise can cause a sharp rise in blood pressure while you are doing it — especially if you strain or hold your breath — people with poorly controlled hypertension or significant heart or blood-vessel disease should seek medical advice first.

It should also be used alongside any medicines and other advice you have been given.

Of course, these exercises are not a replacement for walking, running, swimming or other physical activity such as lifting weights. A mix of different types of exercise is still needed.

Even so, isometric exercise has huge potential, particularly for people who are short on time or find it difficult to manage activities such as walking or lifting heavy weights.

We spend so much time being told that we need to move more to stay healthy, when it turns out that sometimes staying still can be remarkably good for us too.

@drrobgalloway

Life-saving bra tackles a key taboo in first aid

The first few minutes are critical when someone’s heart stops. Despite all the treatments available in hospital, the biggest difference is usually made by CPR, or cardiopulmonary resuscitation, which keeps blood flowing, and by defibrillation, which shocks the heart back into a normal rhythm before the ambulance arrives.

Yet women who suffer a cardiac arrest in public are less likely than men to receive it.

In research for St John Ambulance, 31 per cent of men said they would hesitate to give a woman CPR because they feared accusations of inappropriate touching, while one in five worried about being filmed and posted on social media.

Embarrassment should never stop someone from receiving life-saving treatment. That is why the St John Ambulance CPR Bra campaign is such a brilliant idea. With the words “It’s OK to save my life” printed on it, the bra costs £35, with half of the profit going to the charity. My wife has just bought one!

Fewer than one in ten people in the UK survive a cardiac arrest outside hospital. Nobody should have a lower chance of survival simply because they are a woman. Find out more at sja.org.uk/cpr-bra.