Blood pressure measures the force blood exerts against artery walls. A reading consists of two numbers: systolic pressure (the higher number when the heart beats) and diastolic pressure (the lower number when the heart rests between beats). High blood pressure, or hypertension, is a common condition affecting nearly half of all U.S. adults. Hypertension significantly increases the risk for serious health issues like heart disease and stroke. Regular physical activity is a proven, non-pharmacological strategy to lower elevated blood pressure.
How Exercise Acutely Lowers Blood Pressure
A single session of aerobic exercise can cause an immediate, temporary reduction in blood pressure known as post-exercise hypotension (PEH). This effect begins shortly after the activity ends and can last for several hours. The primary driver of this acute drop is a decrease in peripheral resistance. During recovery, blood vessels, especially those in active muscles, remain widened through a process called vasodilation. This sustained vasodilation is facilitated by reduced activity in the sympathetic nervous system, which normally constricts blood vessels. This temporary drop in blood pressure is more pronounced in individuals who already have hypertension, contributing to better overall blood pressure management.
Chronic Physiological Changes from Regular Activity
Long-term, consistent exercise leads to sustained structural and functional improvements in the cardiovascular system, resulting in a lower resting blood pressure. One significant change is increased heart efficiency, allowing it to pump more blood with fewer beats, which reduces the overall workload and lowers the resting heart rate. Regular physical activity also promotes greater elasticity and flexibility in the arterial walls, known as improved arterial compliance. When arteries are more pliable, they expand and contract more easily, reducing the pressure required to push blood through them. Exercise also moderates neurohormonal systems by reducing levels of vasoconstricting hormones, such as plasma norepinephrine and renin. These adaptations collectively decrease chronic vascular resistance, establishing a lower baseline blood pressure.
Recommended Exercise Types and Intensity
Aerobic exercise has the most consistently demonstrated effect on lowering blood pressure. Activities such as brisk walking, jogging, cycling, or swimming are recommended for 30 to 60 minutes on most days of the week. Guidelines suggest accumulating at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity per week. Moderate intensity is an effort level where you can talk but not sing. Vigorous activity is a higher intensity where conversation becomes difficult. Consistent aerobic training in individuals with hypertension can lead to an average reduction of 5 to 8 mmHg in systolic pressure and 4 to 10 mmHg in diastolic pressure.
Resistance training should be included as a supplement to the aerobic component. Guidelines suggest performing resistance exercises two to three days per week on nonconsecutive days. Sessions involve working the major muscle groups, completing at least one set of eight to twelve repetitions per exercise at a moderate intensity. Resistance training provides benefits for strength and bone density, and it offers a favorable, though less pronounced, effect on lowering blood pressure compared to aerobic exercise.
Safety Precautions and When to Consult a Doctor
Before beginning any new exercise regimen, individuals with uncontrolled high blood pressure should seek medical clearance. Do not start a new, vigorous activity if blood pressure is 180/100 mmHg or higher. In such cases, a doctor may recommend initiating blood pressure medication first to stabilize readings. For those with hypertension, avoid activities involving intense, short bursts of effort, such as heavy weightlifting or sprinting, as these can cause a sudden, sharp rise in blood pressure.
Every exercise session should include a warm-up and a cool-down period. Stopping exercise abruptly can cause blood pressure to drop too quickly, leading to dizziness or lightheadedness. Stop exercising immediately if you experience warning signs, including chest pain, neck or jaw pain, unusual weakness, or severe dizziness. Monitoring blood pressure at home before and after exercise helps ensure the activity is safe. If concerning symptoms do not quickly resolve, seek emergency medical attention.