A new pooled analysis of 31 randomized controlled trials found that certain types of exercise are associated with significant reductions in 24-hour ambulatory blood pressure.
Published in the British Journal of Sports Medicine, the analysis included over 1,345 participants and 67 different exercise formats.
Study Scope and Methods
Researchers analyzed trials published between November 2024 and August 2025. The exercise categories examined included aerobic exercise (e.g., brisk walking, running, cycling), resistance training, isometric exercise (e.g., planks, wall sits), high intensity interval training (HIIT), yoga/pilates, and recreational sports (e.g., football, beach tennis, handball).
Ambulatory blood pressure monitoring, which tracks blood pressure continuously over 24 hours, was the primary measurement tool.
Key Findings on Blood Pressure Reductions
Compared with no exercise, the analysis reported the following average reductions in systolic and diastolic blood pressure over 24 hours:
Systolic Blood Pressure Reductions:
- Combined aerobic and resistance training: 6.18 mm Hg
- High intensity interval training (HIIT): 5.71 mm Hg
- Aerobic exercise: 4.73 mm Hg
Diastolic Blood Pressure Reductions:
- High intensity interval training (HIIT): 4.64 mm Hg
- Pilates: 4.18 mm Hg
- Combined aerobic and resistance training: 3.94 mm Hg
- Aerobic exercise: 2.76 mm Hg
Aerobic exercise showed the most consistent reductions in ambulatory blood pressure during both daytime and nighttime periods.
Additional Observations
The researchers noted that the evidence for resistance training alone, isometric exercise, yoga, pilates, and recreational sports was more limited.
The researchers stated that resistance training may be better viewed as complementary, rather than a first-line intervention, for lowering blood pressure.
Study Limitations
The researchers identified several limitations within the analysis, including:
- Small sample sizes in some of the included trials.
- Side effects were often underreported.
- Data on participant adherence to the exercise programs were frequently missing.
- Different classifications of exercise formats across the studies.
Conclusions and Recommendations
The authors of the analysis called for larger, standardized trials to confirm the findings for combined exercise and HIIT.
The current analysis supports including aerobic exercise (continuous or interval) or combined aerobic and resistance training as primary evidence-based interventions for reducing 24-hour ambulatory blood pressure in adults with hypertension.