Many of us associate high blood pressure, or hypertension, with people who lead stressful and unhealthy lives, but in fact it’s one of the most common health issues in the UK.
Around one in three adults experience it, with millions more living with it undiagnosed. Poor diets and sedentary lifestyles have also caused a rise in the number of children living with high blood pressure. But, despite the stark statistics, there are plenty of ways to get your blood pressure under control.
NHS GP Dr Deepali Misra-Sharp explains that hypertension is caused by a combinaton of factors: “Ageing plays a significant role, as blood vessels naturally stiffen. A family history makes it more likely. And lifestyle, such as diet, weight, stress, alcohol, smoking and lack of physical activity, plays a major part.”
She adds that poor sleep can often contribute, especially if you have sleep apnoea (when breathing stops and starts as you sleep) as this can “raise blood pressure by putting the body into a constant state of ‘fight or flight’”. High blood pressure can also be a symptom of other health problems such as kidney disease, thyroid disorders or adrenal conditions. And there are some types of medication such as the contraceptive pill or steroids, where high blood pressure can be a common side effect. If you have a history of high blood pressure in your family or you have any concerns you can visit a pharmacy for a free check.
The NHS says a normal blood pressure reading is between 90/60mmHg and 120/80mmHg. If you’re diagnosed with high blood pressure, you might be given medication, or you may be advised to make some lifestyle changes such as reducing your salt intake, losing weight, cutting back on alcohol and, of course, staying physically active.
High intensity cardio isn’t the answer
Qualified personal trainer Nicole Chapman explains that “aerobic activities like running, cycling and swimming help the body use oxygen more efficiently which lightens the workload on the heart” and helps keep our blood pressure stable. She says these exercises “improve how the blood vessels widen and contract and can lead to steady reductions in resting blood pressure”.
“These activities are also helpful because they increase overall circulation and support healthier blood vessel elasticity, which is something that naturally declines with age and stress,” she adds.
Blood Pressure UK says it’s best to avoid any exercise which is very intensive for short periods of time such as sprinting, squash, weightlifting or skipping. This is because they can cause spikes in your blood pressure which might put too much strain on your heart and blood vessels. Chapman says: “The best choice is the activity you can keep coming back to because regular aerobic movement is what creates the long term effect on blood pressure.”
If you know you have high – or low – blood pressure you should always seek advice from your GP before you start a new exercise programme. A qualified personal trainer will also be able give you some guidance on what is right for your health needs. Misra-Sharp adds: “If someone’s BP is extremely high (more than 180/110mmHg), we advise avoiding vigorous exercise until it’s been reviewed.”
While we know doing any type of moderate exercise is good for keeping blood pressure levels stable and managing hypertension, some research has gone even further to explore which is most beneficial.
Wall squats are better than running
A study published in the British Journal of Sports Medicine in 2023 reviewed 270 blood pressure trials carried out between 1990 and 2023 to compare the impact of five different forms of exercise on participants. They looked at aerobic exercise such as cycling, walking and jogging, isometric exercise, resistance training such as lifting weights, combined training (aerobic and weights) and high-intensity interval training (HIIT).
They found that while all forms improved blood pressure levels, it was isometric exercise which came out on top, and in particular wall squats and the plank. Study author Dr Jamie O’Driscoll, from Canterbury Christ Church University, recommends two minutes of wall squats, or holding the plank position four times with two minutes’ rest in between, three times a week.
Planks were found to be most effective at reducing high blood pressure (Photo: Getty)Steve Chambers, certified personal trainer and gym manager at Ultimate Performance, explains that isometric exercise involves “movements in which the muscles contract and generate tension, but the muscle length does not change, and the joints do not move”. In simple terms, it’s “static hold exercises, rather than moving exercises”.
Consider moves like squats, side planks, glute bridges and handgrips. Isometric exercises are so effective because, as you tense your muscles to hold a move, your blood vessels also tense. When you release, your blood vessels also relax, giving your blood vessels a workout and improving your circulatory system.
Low-impact exercise helps, no matter your fitness level
A 2019 review of 12 clinical trials around hypertension, published in the Journal of Hypertension, found that isometric resistance training (IRT) reduced systolic blood pressure by around 6.2mmHg and diastolic blood pressure by around 2.8mmHg. Mean arterial pressure also reduced by around 4.1mmHg. The 12 studies found the impact was the same on men and women, both under and over the age of 45. The authors said: “The convenience and practicality of employing IRT as a treatment tool are advantageous. IRT exercise can be implemented while seated, at any time of the day, and is easily accessible for most patients with mobility issues.”
Chapman always includes isometric exercises in her sessions because “they are low impact, require no equipment and can help build strength, mobility and joint stability”. She adds that they can also be easily adapted to your fitness level. “If you have wrist pain you can plank on your elbows. If you have knee pain, a wall sit is usually more comfortable than a squat. If you have lower back sensitivity a side plank is often easier than a front plank,” she explains.
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You can squeeze in isometric exercise into your day with minimal distraction when you’re working from home or first thing in the morning. But Chambers warns that they can be tough if you’ve never done them before. “Try to hold a perfect plank position (with your core muscles fully engaged) for 60-90 seconds and your core muscles will be on fire. Build up your strength slowly. Start by holding yourself in isometric exercises for shorter time periods – e.g. 30 seconds – and gradually build up your tolerance over time.”
Personal trainer Michael Baah says most of us can give isometric exercises a go but that it’s important to make sure you “breathe slowly through your nose, stop if you feel unwell and avoid pushing through any dizziness or discomfort”.
Chambers adds: “Many of my clients combine traditional aerobic modalities such as running, rowing, cycling with resistance or isometric training and other healthy lifestyle habits, to form the backbone of a sustainable blood pressure-friendly regimen.”
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