"You Don't Need Expensive Personal Training... The Most Effective Exercise for Hypertension"

Findings from a Brazilian Research Team

Researchers Recommend "Aerobic Exercise First"

Aerobic exercise, combined exercise (aerobic plus strength training), and high-intensity interval training have been found effective in lowering 24-hour ambulatory blood pressure in patients with hypertension. Among these, aerobic exercise showed the most consistent blood pressure reduction throughout both daytime and nighttime periods.

On May 12 (local time), Professor Rodrigo Ferrari and his team at the Federal University of Rio Grande do Sul in Brazil reported in a paper published in the British Journal of Sports Medicine that "aerobic exercise, combined exercise, and high-intensity interval training were significantly associated with reductions in 24-hour ambulatory blood pressure."

The European Society of Cardiology defines hypertension as a systolic blood pressure of 140 mmHg or higher, a diastolic blood pressure of 90 mmHg or higher, or when antihypertensive medication is being taken.

Exercise is recommended as a method for the prevention and treatment of hypertension. While previous studies have shown that various forms of exercise can lower blood pressure, the research team noted that aerobic exercise was the only modality proven to reduce 24-hour ambulatory blood pressure.

To verify this, the researchers analyzed data from comparative clinical trials published between November 2024 and August 2025. The studies included structured exercise programs that lasted at least four weeks.

The types of exercise analyzed ranged widely and included aerobic activities such as brisk walking, running, and cycling; strength training such as weightlifting and bodyweight exercises; isometric exercises such as planks and wall sits; high-intensity interval training; yoga and Pilates; as well as recreational sports like soccer, beach tennis, and handball.

The research team conducted a network meta-analysis that integrated data from 31 randomized controlled trials with more than 1,345 participants and covered 67 different types of exercise.

The analysis showed that both combined exercise and high-intensity interval training led to reductions in 24-hour blood pressure, while aerobic exercise produced the most consistent blood pressure reduction effects during both daytime and nighttime.

Compared to the group that did not exercise, combined exercise reduced 24-hour systolic blood pressure by an average of 6.18 mmHg, aerobic exercise by 4.73 mmHg, and high-intensity interval training by 5.71 mmHg. For diastolic blood pressure, combined exercise lowered it by an average of 3.94 mmHg, aerobic exercise by 2.76 mmHg, and high-intensity interval training by 4.64 mmHg. Pilates also showed a reduction of 4.18 mmHg.

The researchers suggested that strength training is more appropriate as a supplementary exercise method, rather than as a primary strategy for reducing hypertension.

The team further explained that while yoga, Pilates, and recreational sports activities also demonstrated positive effects, larger-scale follow-up studies are necessary before these can be applied clinically.

However, the researchers noted limitations in the study, including the small number of participants in some clinical trials, insufficient reporting of adverse effects, and a lack of comprehensive data on adherence to exercise programs.

The research team added, "There is a possibility that the more frequently exercise is performed, the greater the blood pressure control effect, likely due to the accumulation of post-exercise hypotension. In other words, the more days per week a person exercises, the longer they can experience the acute blood pressure reduction that occurs after each session."