How do cardio training and weightlifting affect blood pressure?

From the Guidelines

Cardio training and weightlifting can both help lower blood pressure, with cardio exercise being the most effective method, reducing systolic blood pressure by 3.0-5.0 mmHg and diastolic blood pressure by 2.4-4.0 mmHg, as supported by the 2013 ESH/ESC guidelines for the management of arterial hypertension 1. The benefits of cardio training on blood pressure are well-established, with regular aerobic exercise, such as walking, jogging, cycling, or swimming, for at least 30 minutes, 5-7 days a week, being recommended to lower blood pressure and reduce cardiovascular risk 1. Weightlifting, on the other hand, can also help lower blood pressure, although the effect is smaller, with a reduction of 2-4 mmHg, and is most effective when combined with cardio exercise 1. When weightlifting, it is recommended to focus on moderate resistance with more repetitions, rather than heavy weights with few reps, and to start with 2-3 sessions per week, using proper breathing techniques to avoid dangerous blood pressure spikes 1. For individuals with hypertension, it is essential to get medical clearance before beginning an exercise program, start gradually, and monitor blood pressure response to different activities, as recommended by the American Heart Association and the American College of Cardiology 1. The blood pressure benefits of regular exercise typically begin within a few weeks of consistent training and continue as long as the routine is maintained, highlighting the importance of long-term adherence to an exercise program 1. Key considerations for individuals with hypertension include:

• Getting medical clearance before starting an exercise program
• Starting gradually and monitoring blood pressure response
• Focusing on moderate-intensity aerobic exercise, such as cardio training
• Incorporating weightlifting as a complementary activity to improve overall fitness
• Avoiding heavy weights and high-intensity exercise, especially for those with stage 2 hypertension or other cardiovascular conditions 1.

From the Research

Effects of Lifting Weights and Cardio Training on Blood Pressure

• Both cardio training and weightlifting have been shown to reduce blood pressure effectively 2, 3
• Aerobic exercise, such as brisk walking, can be recommended to society as an easy and effective way to reduce blood pressure 2
• Resistance exercise, including weightlifting, has also been proven to reduce blood pressure, with a weighted net reduction of diastolic blood pressure of 3.5 mmHg 3
• High-intensity interval training (HIIT) has been found to be non-inferior to lower-to-moderate-intensity aerobic exercise in reducing ambulatory blood pressure, and more effective at increasing cardiorespiratory fitness 4

Mechanisms and Benefits

• Regular exercise can delay the development of hypertension and reduce blood pressure by 5-8 mmHg 2, 5
• Exercise can also reduce systemic vascular resistance, plasma noradrenaline, and plasma renin activity, while increasing high-density lipoprotein-cholesterol and reducing body weight and waist circumference 3
• The reduction in blood pressure can lead to a decrease in mortality due to coronary heart disease, stroke, and all-cause mortality 2

Exercise Recommendations

• Professional organizations and government bodies recommend moderate-intensity aerobic exercise for at least 30 minutes on at least 3 days of the week, or resistance exercise on 2-3 days of the week 2
• An isometric exercise training program of 12-20 minutes per day, 3 times per week, can also improve blood pressure reduction in those with hypertension 5
• Even small increases in physical activity above sedentary levels can achieve clinically significant decreases in blood pressure 6