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Is Weight Training the Key to Lowering Blood Pressure in Adults?

Mar 16, 2023Mar 16, 2023

Brian Mastroianni is a health and science journalist based in New York. His work has been published by The Atlantic, The Paris Review, CBS News, The TODAY Show, Barron's PENTA, Engadget and Healthline, among others.

New research found that individuals who participate in moderate-to-vigorous intensity strength training have a better chance of lowering their blood pressure.

This work fits into a growing understanding of the cardiovascular and overall health benefits of lifting weights. Previous research has already shed light on the fact that strength training combined with cardio workouts can increase longevity. What makes this new study stand out is the role weight training plays in regulating high blood pressure, or hypertension.

This was shown to be most effective for people up to the age of 50, rather than for older adults.

When asked how impactful strength training exercises can be for a person's blood pressure, lead study author Giovanna Rampazzo Teixeira, a professor in the Department of Physical Education at São Paulo State University in Presidente Prudente, said it's important to note that during physical activity there is an increase in one's heart rate, an increase in the diameter of blood vessels, known as vasodilation, greater blood flow, and an increase in the production of nitric oxide, which is "an important mediator in vessel relaxation."

This all has long-term benefits for blood pressure.

"Exercise promotes adaptations such as a decrease in resting heart rate, improvement in cardiac efficiency, and an increase in the maximum volume of oxygen—VO2max," Teixeira told Health.

What this study can do is offer a clearer understanding of just how helpful strength training can be in blood pressure regulation, especially for older adults who might otherwise shy away from lifting weights.

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Teixeira and her team conducted a review of 14 studies that included controlled trials that evaluated the impact of strength training for eight weeks or more in adults with arterial hypertension.

The average participant age was about 59 years, and while most of the studies reviewed had participant age ranges between 60 and 68 years old, just two looked at younger groups with people between 18 and 46 years old.

The results? Strength training was effective at lowering blood pressure for people who engaged in moderate-to-vigorous-intensity strength training about two or three times each week. The authors defined this kind of moderate-to-vigorous "load intensity" as involving more than 60% of the heaviest weight participants could lift just once.

Eight to 10 weeks of this moderate-to-vigorous strength training resulted in a reduction of 10 mmHg in systolic pressure and about 4.8 mmHg in diastolic pressure. One interesting highlight is the fact that blood pressure was lowered significantly more for people from 18 to 50 years old, compared to those who were between 51 and 70 years old.

"During strength training, such as in the middle of a lift, we know that blood pressure actually increases acutely. However, we do know from numerous studies that a strength training program can help reduce blood pressure," explained Jeffrey Hsu, MD, PhD, a cardiologist at UCLA Health.

Dr. Hsu, who is unaffiliated with this latest research, told Health that strength training can have clear effects on other factors that reduce blood pressure overall, such as promoting fat loss.

"Importantly, a healthy exercise program should include both aerobic and strength training," he added.

Tamanna K. Singh, MD, FACC, co-director of the Sports Cardiology Center at Cleveland Clinic, told Health that hypertension is a disease characterized by endothelial dysfunction, a form of non-obstructive coronary artery disease, and following stiffening of arteries.

"Resistance training, or strength training, has been shown to maintain healthy endothelial function and thus correlates to maintaining normal blood pressures," Dr. Singh said.

Dr. Singh added that resistance training "has been shown to reduce blood pressure comparable to blood pressure reduction seen with aerobic activity." While the exact mechanisms behind this aren't fully understood, she noted that some possibilities include the fact that this activity builds more lean muscle mass, which in turn increases one's resting metabolic rate—you burn more calories at rest and increase fat loss.

"We know that weight management and weight reduction contribute to blood pressure reduction," Dr. Singh explained, echoing Dr. Hsu.

Teixeira stressed that while older people had fewer blood pressure benefits from strength training than younger people in the study, this form of exercise is still helpful for older adults looking to manage hypertension.

She explained that older people tend to have "other complications due to age and problems with vascular cells, such as endothelial dysfunction."

"This can influence [the] benefits of exercise. However, that doesn't mean that this population does not have a reduction in blood pressure," Teixeira said. "And this population can benefit not only from the vascular improvement but also from the increase in muscle mass that makes all the difference during senescence, giving more autonomy to the elderly."

Dr. Hsu cited the 2018 Physical Activity Guidelines for Americans from the Department of Health and Human Services, emphasizing the importance of muscle-strengthening exercise involving all major muscle groups at least two times per week.

"Combined aerobic and strength training programs have been shown to have a modest effect on reducing blood pressure—by 2–3 mmHg," Dr. Hsu added. "Additionally, strength training, especially when combined with aerobic training, can help improve risk factors such as high cholesterol levels, diabetes, and obesity, which will ultimately lead to healthier conditions for the heart."

If you’re considering adopting weight training as part of your routine, especially when it comes to lowering blood pressure, Teixeira echoed Dr. Hsu and Dr. Singh in that you should aim for at least two or three times each week.

Dr. Hsu added that it's important not to view weight training exercises as a "magic bullet" to lower your high blood pressure. He recommends a comprehensive exercise program that includes both aerobic and strength training, as well as adopting a healthy diet, of course.

"We clearly have evidence showing that it can reduce blood pressure, which in turn reduces the risk for heart attacks and strokes. Strength training also helps with weight management, blood sugar control—reduced risk of diabetes or better control of diabetes—cholesterol reduction," Dr. Singh said. "All of these are risk factors for heart disease."

While it's clear that weight training is a helpful tool for blood pressure health, there are a variety of methods individuals can use within the weight room. Is there a difference between higher reps and low weight-bearing exercises and lower reps and high weight-bearing exercises when it comes to lowering high blood pressure?

"The main difference between those two is that low weight and high rep typically correlate to increasing muscular endurance while high weight and low rep lead to increases in muscle mass. People benefit from both types of lifting because both muscle endurance and increasing muscle mass—to improve resting metabolic rate and fat loss—can be beneficial for general heart health," Dr. Singh said.

Teixeira said that the number of reps was not investigated in this research, but the intensity was. She noted that as long as you work within that 60% load intensity level, how you go about actually lifting weights shouldn't make much difference in terms of the blood pressure benefits you’ll receive.

"Generally, we recommend weights that a person can perform 10 reps with," Dr. Hsu concluded. "Caution should be taken with heavier weights, particularly in older individuals, as these may increase the risk of musculoskeletal injury during the exercise if the weights exceed one's capacity."

Correia RR, Veras ASC, Tebar WR, Rufino JC, Batista VRG, Teixeira GR. Strength training for arterial hypertension treatment: a systematic review and meta-analysis of randomized clinical trials. Sci Rep. 2023;13(1):201. doi:10.1038/s41598-022-26583-3

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