A weekly session of isometric exercise training may maintain lower blood pressure
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Reductions in blood pressure may be maintained over the short term with just one or two sessions of isometric exercise training a week, research published online in the journal BMJ Open Sport & Exercise Medicine suggests.
Doing this form of exercise three times a week may maintain the blood pressure benefits over a longer period, the findings suggest. For people unable to commit to training more often, even one session a week can help maintain significant health benefits, the researchers say.
Isometric exercise training involves holding a pose for a few minutes at a time. Examples include remaining in a squat, holding a plank or doing a handgrip exercise.
Previously published studies have shown that isometric exercise training reduces blood pressure more than other forms of exercise and can produce an effect similar to or greater than some drug treatments. But it has not been established how frequently people must do the exercises to retain these benefits.
Who joined the trial
To find out, researchers recruited 100 adults with an average age of 37.4 years and normal to high-normal systolic blood pressure (120–140 mmHg) who did not regularly participate in structured exercise.
According to expert guidelines, 130–139 mmHg is classified as "high-normal" blood pressure and should trigger specific medical advice on lifestyle, but the study participants did not have hypertension.
Participants were included only if they had no injuries or illnesses, were not taking and had not previously taken blood pressure medication, did not smoke and did not consume more than 14 units of alcohol per week.
Four weeks of wall squats
The participants were randomly assigned to five groups: a control group and four groups that followed the same initial four-week home-based lower-body isometric exercise training program. The program comprised four bouts of wall-squat exercise separated by two minutes of seated rest, three times a week.
For the following four weeks, one group continued to exercise three times a week, a second group exercised twice a week, and a third group exercised once a week. The remaining group stopped the exercises entirely.
Blood pressure, heart rate and other cardiac measurements were taken at the start of the study and after four and eight weeks.
Fewer sessions preserved some gains
Consistent with previous research, all the groups that completed the initial four-week exercise program showed significant reductions in systolic blood pressure, diastolic blood pressure and mean arterial pressure after four weeks compared with the control group. Once the groups were separated at four weeks, there was no longer a statistically significant difference in diastolic blood pressure for any of the groups.
At eight weeks, the groups that exercised once or twice a week maintained significant reductions in systolic blood pressure and mean arterial pressure, but not diastolic pressure, compared with the control group.
Those who continued isometric exercise training three times a week maintained their blood pressure reductions and achieved the greatest reduction (-13.73 mmHg) in systolic blood pressure compared with the start of the study. That compares with a reduction of 6.95 mmHg for those who exercised twice a week and 6.56 mmHg for those who exercised once a week.
They also maintained improvements in other cardiac measures, including total peripheral resistance (an indication that blood vessels have narrowed) and heart rate variability.
The group that stopped doing the isometric exercises after the initial four-week period saw its blood pressure return to levels not significantly different from those of the control group.
Longer-term benefits remain uncertain
A limitation of the study is that the follow-up period for the maintenance phase was only four weeks. Longer-term studies are needed.
"The study demonstrates that while lower frequency isometric exercise training may be sufficient to maintain blood pressure reductions over the short term, higher frequencies are required to preserve these benefits and the associated vascular and cardiac autonomic adaptations," the researchers write.
"The study offers evidence that lower frequency isometric exercise training can help maintain short-term blood pressure reductions, providing a pragmatic option for individuals with limited time or adherence challenges."
Publication details
Isometric exercise training and blood pressure control: exploring the dose-response to training frequency in a randomised controlled trial, BMJ Open Sport & Exercise Medicine (2026). DOI: 10.1136/bmjsem-2025-003172
Journal information: BMJ Open Sport & Exercise Medicine
Key medical concepts
Systolic blood pressureDiastolic blood pressure
Clinical categories
CardiologyFitness & Physical activityPreventive medicineHealthy livingCommon illnesses & Prevention Provided by British Medical Journal Who's behind this story?
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