A review of 270 controlled studies with a total of 15,827 participants found that all forms of exercise can help to lower high blood pressure: aerobic exercise, resistance strength training, combined aerobic and resistance training, high-intensity interval training and isometric exercise training (Br J Sports Med, 2023;57(20):1317–1326). Surprisingly, isometric exercise training was found to be the most effective way to lower both systolic and diastolic blood pressure. All studies in this review measured exercise periods of at least two weeks.

Regular exercise has been shown in many studies to reduce risk for heart attacks, some cancers, diabetes, obesity, kidney failure, osteoporosis, gallstones, depression and dementia (Arq Bras Cardiol, 2016 May; 106(5): 422–433). The U.S. Centers for Disease Control and Prevention (CDC) reports that more than 116 million North American adults have high blood pressure, and fewer than 24 percent are able to get their blood pressures to a safer level below 140/90. Nineteen percent of adults have hypertension that cannot be brought to normal with any combination of medications (Hypertension, 2019;73(2):424–431).

How Exercise Helps to Lower Blood Pressure
Several recent articles show that exercise might help to lower high blood pressure by changing the bacteria in your colon. One study found that people with high blood pressure are likely to have Bacteroides2 (colon bacteria associated with eating meat), and reduced amounts of bacteria that are associated with eating a plant-based diet (Front Microbiomes, May 26, 2023;2). When these people changed to an anti-inflammatory plant-based diet that restricted meat, their blood pressures were reduced significantly, as were the number of colon bacteria associated with eating meat, and the colon bacteria associated with eating plant-based foods increased.

It is agreed by most of these researchers that a plant-based diet helps to lower high blood pressure because all plants contain soluble fiber that cannot be absorbed in the upper intestinal tract. When soluble fiber reaches the colon, bacteria there convert it into short chain fatty acids (SCFAs) that are absorbed into the bloodstream and help lower high blood pressure (Curr Hypertens Rep, 2017 Apr19(4): 25), high cholesterol (J Agric Food Chem, 2017 Dec 20;65(50):10984-10992) and inflammation (Curr Hypertens Rep, April 2017;19(4):25). People who have high blood pressure have lower colon levels of bacteria that make SCFAs (Front Cell Infect Microbiol, 24 August 2017;7), and exercise increases the number of the colon bacteria that make SCFAs (Oxid Med Cell Longev, 2017: 3831972).

Lifting Weights to Help Lower Blood Pressure
Exercising temporarily increases blood pressure and heart rate, widens blood vessels and increases blood flow. It increases blood flow by significantly widening blood vessels by relaxing the autonomic nervous system (Circ Res, 2017, Jan 20; 120(2): 249–251) and increasing production of nitric oxide that widens blood vessels. Nitric oxide remains elevated after exercising, and blood pressure is usually lower for a while after you finish exercising. This applies to both aerobic and resistance exercises. Exercise strengthens heart muscles and blood vessels, so blood vessels can remain relaxed to continue at a lowered blood pressure (Curr Hypertens Rep, 2015;17(10):77).

A review of 14 studies of 253 people with high blood pressure, average age 60, found that lifting weights for eight weeks or longer lowered high blood pressure by the twentieth training session, and the blood pressure stayed lower for 14 weeks after the people stopped lifting weights (Scientific Reports, January 2023;13(1):201). Eight to ten weeks of strength training led to a reduction of 10 mmHg in systolic pressure and 4.8 mmHg in diastolic pressure. Strength training was most effective in lowering high blood pressure when people lifted more than 60 percent of the maximum weight that they could lift (one rep max), and they lifted at least twice a week for at least eight weeks.

Caution with resistance exercise: A person can suffer a stroke or heart attack while lifting heavy weights because during heavy lifting, high blood pressure rises even higher. Many doctors recommend resistance exercises to help treat high blood pressure, but people with high blood pressure need to be very careful if they try to lift heavy weights. Instead, they should lift lighter weights with more repetitions and stop doing a lift if they feel pain.

Who is Likely to Develop High Blood Pressure?
You are considered to have high blood pressure if your systolic blood pressure is greater than 120 before you go to bed at night or just after you wake in the morning (when your blood pressure is at its lowest level). You may also have high blood pressure if your systolic pressure is greater than 140 after resting for 5-10 minutes during the day. A report in the Journal of Hypertension (J of Hypertension, March 5, 2019) lists risk factors for developing high blood pressure:
• high resting heart rate (>70)
• overweight (BMI>25)
• high LDL cholesterol (>100)
• high uric acid level (>6.0 mg/dL)
• high blood sugar (>145 one hour after a meal)
• low glomerular filtration rate (a test of kidney function)
Having two of these factors doubles your chances of suffering high blood pressure and having three almost triples your chances.

Other risk factors for high blood pressure include:
• not exercising
• eating an unhealthful diet
• drinking alcohol
• smoking or exposure to smoke
• having sleep apnea
• being diabetic

My Recommendations
If you have high blood pressure, you should check with your doctor about lowering high blood pressure by exercising, losing excess weight and eating a plant-based diet that severely restricts mammal and processed meats. You cannot cure high blood pressure with drugs; you can only control it as long as you continue to take the drugs (Hypertension, 2002;40(5):612-618). Most of the time, your blood pressure cannot be controlled with just one drug and most people end up with three or more drugs to treat their high blood pressure. On the other hand, some people are able to cure their high blood pressure by making lifestyle changes. A regular exercise program is an important part of lowering high blood pressure and extending your lifespan.