How to reduce your blood pressure without pills… and without moving: The growing evidence that suggests a simple exercise could help lower your BP

If I told you that one of the most effective ways of lowering your blood pressure involved not moving, you might think I’d misunderstood the whole point of exercise.

Yet growing scientific evidence suggests that some of the best exercises for lowering blood pressure involve staying almost completely still.

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

Traditionally, much of our medical approach to controlling blood pressure has involved prescribing tablets and advising on lifestyle changes – such as losing weight, eating less salt and taking exercise, such as walks or runs.

But new research published in the BMJ Open Sport & Exercise Medicine has provided evidence of another – very surprising – way we can significantly lower our blood pressure.

In a study by Canterbury Christ Church University in Kent, adults with normal or slightly raised blood pressure were asked to do a ‘wall sit’, three times a week for four weeks. (This involves holding yourself in a sitting position against a wall as if you’re on a chair – but there isn’t one.)

Each session involved four two-minute wall sits, with two minutes’ rest between each. So a total of eight minutes of actual ‘exercise’.

The results were remarkable. After just four weeks, the people doing the wall sits experienced an average 9.5mmHg drop in systolic blood pressure (the top number in a reading) while their diastolic pressure (the bottom number) fell by around 5.5mmHg, compared with participants who didn’t do the wall sits.

These are significant improvements when you consider that a standard dose of a single blood pressure medication lowers blood pressure by an average 9mmHg and 5mmHg, respectively.

The researchers then looked at what happened when people continued the wall-sitting exercises for another four weeks or stopped.

Those who carried on maintained the greatest benefits – even doing them just once a week helped keep blood pressure down.

However, the participants who stopped saw their blood pressure return towards its original level.

So what’s going on? During wall sits, you contract your muscles without moving; this is known as isometric exercise.

Most of the exercise we do day to day involves our muscles repeatedly shortening and lengthening as we move. But with isometric exercise, the muscles are still working hard, but they remain in roughly the same position because you are resisting gravity.

In fact, this wasn’t the first time we’d learned that this type of exercise could lower blood pressure.

In 2023, a major analysis in the British Journal of Sports Medicine – which brought together 270 trials – showed that isometric exercise including wall sits, squeezing a handgrip device and holding your legs still against resistance reduced systolic blood pressure by over 8mmHg.

That’s almost twice the reduction seen with conventional aerobic exercise, such as running or cycling.

But this latest study goes further – showing not only how quickly blood pressure can improve, but how often you need to keep doing these exercises to maintain the benefits.

There are other forms of isometric exercise which could help too – such as standing and pushing against a wall; holding a plank; lying on your back with your legs raised; holding weights without moving them (such as when carrying heavy shopping bags); or even hanging from a bar.

In all these exercises, your muscles are working even though you’re not moving.

What makes these findings particularly surprising is that, although isometric exercise lowers blood pressure over time, it causes blood pressure to rise while you’re doing it.

This is because when we do a wall sit, or hold a heavy shopping bag, the muscles contract, squeezing the small blood vessels running through them which makes it harder for blood to flow.

At the same time, because the muscles are working hard, they need more oxygen and they signal this to the brain by producing substances such as lactate that stimulate the nerve endings.

The body’s response is to fire up the sympathetic nervous system, the same one involved in our fight-or-flight response, making the heart pump faster and raising blood pressure.

But then when you finally relax, the pressure on the small blood vessels is released and blood can rush back through.

This stimulates the lining of the vessels to produce compounds such as nitric oxide, which widens them.

As the muscles relax and the body’s immediate stress response settles, blood pressure falls. Repeatedly going through this process appears to help blood vessels relax more easily and efficiently and improves the body’s ability to control blood pressure.

So although your blood pressure rises during the exercise, whether it’s holding heavy weights or wall sits, over time it can become lower.

There is a parallel here with another increasingly popular health habit – taking cold showers or cold-water immersion.

When you first step under very cold water, your body experiences a sudden physical stress.

Your breathing becomes faster, blood vessels in the skin narrow and your nervous system releases stress-related chemicals, particularly noradrenaline, which help prepare the body to respond.

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

However, studies have shown when people are repeatedly exposed to cold water, some of these immediate reactions become less dramatic – including reducing the release of those stress-related chemicals.

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

Our bodies are remarkably capable of adapting to repeated challenges, and what initially produces a strong response can, with repetition, lead to important and beneficial changes.

In the case of isometric exercise, we now have proof that it leads to lower blood pressure.

And what’s so encouraging is the amount of ‘exercise’ required isn’t particularly demanding in terms of time.

Even if you can’t do wall sits, any isometric exercise can help – such as holding weights with your arms straight out in front or squeezing a handgrip for a few minutes. Start slowly.

But one health warning. As isometric exercise can produce quite a sharp rise in blood pressure while 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.

And the exercise programme should also be complementary to any medications and any other advice you’re given.

Of course, these exercises are not a substitute for walking, running, swimming or other forms of physical activity such as lifting weights. You need to do a combination of different types of exercise.

However, I think isometric exercise has enormous potential, particularly if you’re time-pressed or find it difficult to undertake things like walking or lifting heavy weights.

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

@drrobgalloway

Life-saving bra tackling first aid’s big taboo 

The first few minutes are crucial when someone’s heart stops. Despite all the treatments we have in hospital, what makes the biggest difference by far is CPR (or cardiopulmonary resuscitation) – chest compressions that keep blood flowing, as well as defibrillation (where the heart is shocked back into normal rhythm) before the ambulance arrives.

Yet women who have 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 for fear of accusations of inappropriate touching, while one in five worried about being filmed and posted on social media.

Embarrassment must never prevent someone receiving life-saving treatment. That is why the St John Ambulance CPR Bra campaign is brilliant. With the words ‘It’s OK to save my life’ on it, the bra costs £35 (half of the profit goes 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 surviving simply because they’re a woman. Find out more at sja.org.uk/cpr-bra.