Did you know that 57% of adults have hypertension? Yet, all adults, young and old, need resistance training to preserve strength and muscle mass and stay healthy as the years go by. Without resistance training, muscle loss begins after the age of 30 and speeds up later in life. In fact, loss of muscle strength and power is the reason people become frail in the latter decades of life.
Maintaining good muscle strength may even prolong life. A study published in the Journal of Gerontology discovered that subjects who lacked muscle strength had a 50% greater mortality relative to the strongest ones. Sounds like a good reason to strength train, doesn’t it?
But what if you have high blood pressure? You might wonder whether resistance training, working your muscles against resistance using weights or your own body weight, influences blood pressure. Studies show that aerobic exercise that raises the heart rate for sustained periods of time can modestly lower blood pressure. You might wonder whether strength training offers similar benefit and whether resistance training can lower blood pressure as much as aerobic exercise? Let’s look at what science shows.
Resistance Training and Blood Pressure
If you have hypertension and engage in resistance training, there’s good news. An analysis of 64 studies looking at the effects of resistance training on blood pressure found that working muscles against resistance can lower blood pressure in people with hypertension. This analysis, published in the Journal of the American Heart Association, found that dynamic resistance training reduced systolic blood pressure by an average of 6 points and diastolic by 3 points, on average.
As the researchers in the study point out, the drop in blood pressure from dynamic resistance training rivals that of aerobic exercise and, sometimes, is more pronounced than declines in blood pressure in response to aerobic exercise. The analysis found the blood pressure-lowering benefits were greatest in non-whites and subjects who weren’t currently taking medications to control blood pressure.
What is dynamic resistance training? It’s working muscles against resistance dynamically and includes movements like squats where the muscles change angles. This is in contrast to isometric resistance training, where the muscle holds tension but doesn’t move or change angles. An example of an isometric exercise is planks, where you hold your muscles in a fixed position against gravity. It’s less clear whether isometric exercises offer the same blood pressure benefits. At least one study finds that isometric exercises offer similar or even greater benefits than dynamic resistance training, but this needs further study.
On a more optimistic note, a meta-analysis of 28 randomized clinical trials published in 2011 in the American Heart Association Journal found that that both dynamic and static resistance training lowers blood pressure. In fact, the blood pressure drops were greater with static, or isometric, resistance exercise than with dynamic resistance training. Subjects who didn’t have hypertension or who were pre-hypertensive, meaning their blood pressure was in the borderline range, experienced the greatest drops in blood pressure. Blood pressure declines for people with established hypertension were not as pronounced.
Precautions When Lifting with High Blood Pressure
Despite its apparent blood pressure-lowering benefits, working with weights can cause a temporary, often substantial, rise in blood pressure during a lift. Studies show blood pressure can reach values as high as 320-250 mmHg during intense weight training. However, these blood pressure spikes are short-lived. But it’s important to take precautions to prevent large blood pressure spikes during weight training.
One way to reduce the blood pressure rise when you lift is to breathe while lifting. The worst thing you can do for your blood pressure is to hold your breath. Breath-holding during a lift can cause a more pronounced blood pressure spike that might be dangerous for people with poorly controlled hypertension.
If you have high blood pressure, the safest approach is to work with lighter weights and do more repetitions to fatigue the muscles you’re working. Lifting heavier weights causes a greater rise in blood pressure than lighter ones. It makes sense since you strain harder on a heavier lift and that causes blood vessels to constrict.
If you have hypertension, especially if you take blood pressure medications, talk to your physician before weight training, especially if you lift heavy. Keep tabs on your blood pressure by checking it in the morning and evening and recording the values. Show the readings to your doctor. Also, if you have a condition like an aneurysm where a rise in blood pressure could be dangerous, don’t lift weights without consulting your doctor. Although resistance training can lower blood pressure, you can experience a sharp, but brief rise, during a lift.
The Bottom Line
Research suggests that dynamic resistance training may lower blood pressure as effectively as aerobic exercise. However, aerobic exercise offers other heart health benefits, so don’t stop doing it. For example, aerobic training has favorable effects on blood lipids and blood glucose levels. Resistance training can also improve insulin sensitivity and reduce blood sugar, although the studies looking at the effects on blood lipids are inconsistent.
Include both in your routine and, if you have hypertension, lift lighter weights and do more repetitions. Be sure to breathe throughout every lift. Also, work on improving your technique when you lift to get the most benefits.
References:
- Journal of the American Heart Association. October 3, 2016, Vol 5, Issue 10.
- org. “Weightlifting: Bad for your blood pressure?”
- J Appl Physiol (1985). 1985 Mar;58(3):785-90. doi: 10.1152/jappl.1985.58.3.785.
- Sports Med. 2014 Mar;44(3):345-56. doi: 10.1007/s40279-013-0118-x.
- Jeffrey Metter, Laura A. Talbot, Matthew Schrager, Robin Conwit, Skeletal Muscle Strength as a Predictor of All-Cause Mortality in Healthy Men, The Journals of Gerontology: Series A, Volume 57, Issue 10, 1 October 2002, Pages B359-B365, https://doi.org/10.1093/gerona/57.10.B359.
- “Resistance Training and High Blood Pressure ….” 10 Jan. 2019, https://www.highbloodpressureinfo.org/resistance-training.html.
- “Impact of Resistance Training on Blood Pressure and Other ….” https://www.ahajournals.org/doi/full/10.1161/hypertensionaha.111.177071.
- MacDougall, J.D., Tuxen, D., Sale, D.G., Moroz, J.R., & Sutton, J.R., (1985). Arterial blood pressure response to heavy resistance exercise. Journal of Applied Physiology, 58(3): 785-790.
- MacDougall, J.D., Tuxen, D., Sale, D.G., Moroz, J.R., & Sutton, J.R., (1985). Arterial blood pressure response to heavy resistance exercise. Journal of Applied Physiology, 58(3): 785-790.
- Tambalis K, Panagiotakos DB, Kavouras SA, Sidossis LS. Responses of blood lipids to aerobic, resistance, and combined aerobic with resistance exercise training: a systematic review of current evidence. Angiology. 2009 Oct-Nov;60(5):614-32. doi: 10.1177/0003319708324927. Epub 2008 Oct 30. PMID: 18974201.
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