Resistance training does much more than build strong muscles and bones, but does lifting weights lower blood pressure too? Research in the past few years has confirmed that lifting weights changes human metabolism in ways that improve health, including for those with high blood pressure.

Background

  • Blood pressure generates two readings: systolic pressure during heart contraction (i.e., ejection of blood) and diastolic pressure during ventricular filling.
  • Normal readings are below 120 for systolic blood pressure and below 80 for diastolic blood pressure.
  • High blood pressure, or hypertension, is indicated by a systolic reading of 140-plus and a diastolic reading of 90-plus. Prehypertension means the reading falls between normal range and high range (AHA 2019).
  • Eighty million adults 20 and older have hypertension, which is a major risk factor for heart disease and stroke. An estimated 41.4% of adults are expected to have high blood pressure in 2030 (Mozaffarian et al. 2015).

Resistance Training Research in Hypertensive Populations

Optimum dose for blood pressure improvement. Scientists have evaluated the dose-response relationship between resistance exercise and changes in blood pressure (Westcott et al. 2009). For 10 weeks, 1,619 untrained and sedentary adults (77% women, 23% men; aged 21–80) engaged in one, two or three exercise sessions per week. Each session consisted of 20 minutes of aerobic training (70%–80% of age-predicted HRmax; rating of perceived exertion under 15) and 20 minutes of weight training (1 set; 8–12 repetitions to volitional fatigue; 10 exercises, working the whole body).

On average, systolic blood pressure fell by 3.83 and diastolic pressure fell by 1.73. The researchers concluded that two or three training sessions a week appeared to do the most good for managing or lowering blood pressure (if elevated).

Peripheral heart action (PHA). In 2015, research using peripheral heart action training provided evidence that weight training can reduce blood pressure directly (Piras et al. 2015). With PHA training, participants sequentially alternate upper- and lower-body exercises in a circuit. The theory is that this type of training enhances blood flow through the body.

Subjects performed four rounds of circuit resistance training (15 reps at 55%–60% of 1-RM) in this order: chest press, leg extension, latissimus dorsi pulldown, hamstring curl, shoulder press and heel raises (note the alternating upper- and lower-body sequence). There was no rest between sets and only 1 minute of rest between circuits.

After 30 training sessions (3 per week, on nonconsecutive days, over 3 months), PHA participants had significantly reduced their systolic (-2.59) and mean arterial (-1.69) blood pressure. Mean arterial blood pressure is the average blood pressure in a person’s arteries during one heartbeat. These results corroborate a research review by Cornelissen & Smart (2013), which analyzed 93 studies and concluded that resistance training reduces systolic pressure (-1.8, on average) and diastolic pressure (-3.2, on average).

See also: 5 Resistance Training Workouts That Improve VO2max

How Does Lifting Weights Lower Blood Pressure?

Though most research on training and blood pressure focuses on the influence of cardio exercises, some interesting findings on resistance training have emerged. For instance, one experiment examined the effects of 1 year of weight training on vascular structure and function in overweight, but otherwise healthy, women (Olson et al. 2006). The primary finding was that weight training alone improved brachial artery endothelial function in this group. The endothelium is a membrane on the inside of blood vessels in the body and heart. Endothelial cells release substances that control blood vessel contraction, relaxation, clotting and immune function. They are deeply involved in blood pressure regulation.

In another study with 18- to 35-year-old adults diagnosed with prehypertension (Beck et al. 2013), an 8-week resistance training program (3 times per week) reduced peripheral blood pressure (arms, hands, legs and feet), improved endothelial function and enhanced other blood vessel substances involved in the regulation of vascular tone (the degree of constriction in blood vessels when fully open).

Practical Recommendations

To protect prehypertensive and hypertensive clients and to improve endothelial function, make sure resistance training is not performed to concentric failure. In a research review (de Sousa et al. 2017), programs that successfully reduced blood pressure (when elevated) had participants doing 7–10 exercises (working the major muscles of the body) 3 days per week at 40%–80% of 1-RM. Participants progressed to 2–3 sets of 8–15 repetitions, with 60-180 seconds of rest between sets.

See also: Metabolism and Strength Training