Static isometric exercises, which are exercises that involve tightening muscles without moving, may be particularly good at lowering blood pressure. At least that is what a meta-analysis of 270 studies reported by a British research team in the British Journal of Sports Medicine suggests. For a German expert, the work underlines above all how effective the “drug sport” is.
High blood pressure has long been a widespread global disease: in 2021, a study published in the journal “The Lancet” showed that the number of sufferers in 200 countries examined doubled to almost 1.3 billion between 1990 and 2019. According to the German Hypertension League, there are between 20 and 30 million people in Germany. Left untreated, hypertension can lead to kidney damage, cardiovascular disease and stroke.
However, there are now numerous effective drug and non-drug treatment options, which include regular exercise in addition to an appropriate diet. Recommendations often focus on moderate endurance training, such as walking, swimming or cycling.
However, as a research group from the British Canterbury Christ Church University and the University of Leicester has now worked out, such recommendations may need to be updated and expanded to include new forms of training. The scientists came to this conclusion after evaluating 270 studies that were published between 1990 and February 2023 and included a total of almost 16,000 participants.
The studies looked at the effects of different forms of exercise done for at least two weeks on blood pressure. The authors defined a resting value below 130 to 85 as healthy blood pressure and a value above 140 to 90 as high blood pressure.
Ski squat can also be done at home and without snow and skis: Just like with forearm support, no tools are required
Quelle: Getty Images/PhotoAlto
The analysis showed that all of the forms of training examined were able to lower both the upper (systolic) and lower (diastolic) value – albeit with different degrees of effectiveness. Isometric exercises – such as planks, ski squats, wall sits or hand grip strength exercises – caused the values in people with hypertension to drop the most: by an average of 8.24 to 4 points.
Combination of endurance and dynamic strength training effective
This was followed by a combination of endurance and dynamic strength training (minus 6.04 to 2.54), dynamic strength training alone (minus 4.55 to 3.04), endurance training alone (minus 4.49 to 2.53) and interval training with high intensity (HIIT) (down 4.08 to 2.50). In people with normal or slightly elevated blood pressure, the reductions were less pronounced or not at all.
For sports physician and circulatory researcher Hans-Georg Predel from the German Sport University, the advantages of isometric strengthening exercises for hypertension patients are nothing new: “We have been using them for a long time because they are easy to use and do not require any equipment.” Instruction should start: “The ski squat, for example, tempts you to press your breath, which people with high blood pressure should definitely avoid.” That’s why inexperienced people should turn to health-oriented sports studios or physiotherapists.
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But why can supposedly simple exercises such as firmly pressing a foam ball or hand trainer (grip strength training) or the wall sit be so effective? Predel, who is also spokesman for the sports medicine section of the German Hypertension League, attributes this to several mechanisms: On the one hand, muscular training as such increases the elasticity of the blood vessels and improves blood circulation. On the other hand, exercising muscles release so-called myokines. These hormone-like substances would affect many cardiovascular and metabolic parameters, which in turn would have a positive impact on blood pressure.
Consequently, it may indeed be time to update hypertension recommendations, as the authors of the meta-analysis suggest. The recently published new guidelines of the European Hypertension Society would mention the advantages of isometric and strengthening exercises, but still put endurance training in the foreground.
Basically – and both the authors of the current work and Hans-Georg Predel emphasize this – all forms of training listed in the meta-analysis would reduce high blood pressure. In general, the effects of regular exercise are comparable to those of medication, explains the expert from the German Sport University: “The drug sport brings about as much as an established blood pressure drug. Yet it is still dramatically underrated and drastically underutilized.”
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According to Predel, no great sporting ambitions are necessary: ”Walking or cycling in the fresh air three to four times a week and doing one or two 15 to 20-minute isometric and vigorous exercises that you can also do at home is enough.”
However, it is important to exercise regularly and consistently. A systematic plan can help. Hypertensive patients with greater athletic ambitions should seek medical advice before beginning their exercise program. All in all, the positive effect of regular exercise is quickly visible, Predel promises: “The effects on blood pressure become apparent as soon as you have invested three to four weeks in your quality of life.”
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