How Exercise Helps Reduce Blood Pressure

Exercise is an essential non-pharmaceutical approach to hypertension (high blood pressure) alongside changes in diet and weight management.² It makes the heart stronger by increasing cardiac output (the volume of blood pumped by the heart per minute).³

While exercise will temporarily increase blood pressure during a workout, it exerts beneficial stress on the circulatory system that can help lower blood pressure over time.

It does so in four key ways:

• Improved vascular function: Hypertension is associated with the hardening and narrowing of arteries. Exercise places beneficial stress on endothelial cells lining arterial walls, stimulating the release of a gas called nitric oxide (NO) that relaxes blood vessels and increases blood flow.²
• Reduced vascular resistance: Exercise stimulates angiogenesis (the formation of new capillaries). By increasing the size and number of capillaries, the overall resistance to blood in the body is decreased, lowering blood pressure.²
• Lower cholesterol: High cholesterol is linked to hypertension as it causes the formation of fatty plaques on arterial walls. Exercise helps reduce levels of low-density lipoprotein (LDL) cholesterol that forms plaques and also increases beneficial high-density lipoprotein (HDL) cholesterol that helps clear LDL from the blood.³
• Improved glucose control: High blood sugar contributes to hypertension by directly damaging arteries. Exercise helps counter this effect by increasing the uptake of glucose (blood sugar) in muscles for energy, thereby lowering blood sugar levels.²

Routine exercise also helps shed pounds if you are overweight or have obesity, both of which place stress on the heart and increase the risk of type 2 diabetes and metabolic syndrome.⁴

How Much Does Exercise Help?

Hypertension is diagnosed when blood pressure readings are consistently at or above 130/80 millimeters of mercury (mmHg).⁵ With routine exercise, even modest reductions in your systolic (upper) and diastolic (lower) blood pressure can influence your risk of heart disease.

A 2015 review of studies suggests that routine exercise can help reduce systolic blood pressure (SBP) by up to 6.9 mmHg and diastolic blood pressure (DBP) by up to 4.9 mmHg, on average.⁶

The benefits of such decreases can be enormous. Even a 5 mmHg reduction in SBP can independently reduce the risk of a major cardiovascular event, like a heart attack or stroke, by 10%.⁷

Moreover, with every 10 mmHg reduction in SBP:¹

• The risk of a major cardiovascular event is decreased by 20%.
• The risk of coronary artery disease is decreased by 17%.
• The risk of a stroke is decreased by 27%.
• The risk of heart failure is decreased by 28%
• The risk of all-cause mortality is decreased by 13%.

How Much Exercise Is Needed?

The benefits of exercise on blood pressure are dose-dependent, meaning that the more you put in, the more you get out. This includes the intensity and duration of exercise and also the type and frequency of exercises you engage in.⁶

Adults can reduce their risk of heart disease by:⁸

• Engaging in at least 150 minutes of moderate-intensity aerobic exercise per week or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of both.
• Spreading out workouts so that you exercise on most days of the week.
• Increasing the duration and intensity of exercise gradually over time.
• Adding muscle-strengthening exercises (such as resistance or weight training) at least two days a week.

You can gain even more benefits by increasing workouts to at least 300 minutes (five hours) per week.⁸

What Types of Exercise Should I Do?

Any physical activity that moves your body and burns calories is beneficial to your blood pressure. With that said, you need to maintain the appropriate level for a minimum amount of time to achieve tangible benefits.

This includes aerobic exercises (“cardio”) that increase your heart rate and breathing rate, as well as strength and resistance training that help build lean muscle.⁹

Moderate-intensity aerobic exercises are those in which you breathe heavily but can still talk during the workout. Examples include:⁸

• Brisk walking (at least 2.5 miles per hour)
• Cycling (slower than 10 miles per hour)
• Social dancing
• Playing doubles tennis
• Water aerobics
• Gardening (such as mowing and raking)

Vigorous aerobic exercises, also known as high-intensity aerobics, are those in which you sweat and have difficulty talking while exercising. Examples include:⁸

• Running
• Cycling (10 miles per hour or faster)
• Swimming laps
• Vigorous aerobic dancing
• Playing singles tennis
• Heavy yardwork (such as continuous digging or hoeing)
• Jumping rope
• Hiking uphill or with a backpack

Strength and resistance training involve different exercises that use gravity and/or external resistance to build muscle strength, endurance, and size. Examples include:¹⁰

• Calistenics
• Isometrics
• Resistance band training
• Free weights
• Weight machines
• Circuit training

Studies have shown that the combination of aerobics and strength training reduces the risk of heart disease more effectively than either one alone.⁹

Before You Start

Consult with your healthcare provider to ensure that any exercise program is safe and suitable for your age and overall health. Additionally, consider working with a physical therapist or personal trainer to ensure you maintain proper form and avoid injury.

Exercise should never be regarded as a substitute for any hypertension medications you have been prescribed.

Key Takeaways

• Routine exercise lowers blood pressure by strengthening the heart, increasing the number and elasticity of blood vessels, and reducing cholesterol and blood sugar levels that can damage arteries.
• By lowering blood pressure, exercise can help reduce the risk of a heart attack or stroke by 20%.
• Adults should engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week, plus strength training at least two days a week.