Recent research has shown that it is possible to effectively lower blood pressure with a few simple home exercises. While it had previously been shown that isometric hand squeeze exercises reduce blood pressure by 8 mmHg, Edwards et al. (5) recently proved that wall squat isometric contractions are more effective than hand squeeze exercises, as they lower blood pressure by more than 11 mmHg. Apparently, the more muscles you contract, the greater the reduction in blood pressure, explaining why the wall squat exercise was so effective. The authors make the important statement that wall squat exercises are not only beneficial in managing high blood pressure, but they may also be helpful in preventing this difficult to treat condition. 

Because the reductions in blood pressure are related to the volume of muscle mass activated with the contractions, this exercise can be modified by performing a wall squat while tensing as many muscles as possible (see above). The 4×2-minute protocol performed to moderate fatigue three times per week is an extremely effective way to safely reduce blood pressure. A great benefit of this exercise is that after following the routine for three weeks, you only need to do it once a week to keep your blood pressure at its improved level (5). 

Importantly, people with a history of poorly controlled hypertension should consult their doctor before beginning this exercise.

In addition to prolonged isometric contractions, another effective way to lower blood pressure is to strengthen your diaphragm. In 2021, da Silva et al. (6) published a meta-analysis evaluating the efficacy of diaphragm strengthening for lowering blood pressure and noted that when resistance is applied during inspiratory muscle training, systolic pressures drop by almost 16 mmHg and diastolic pressures drop by 7 mmHg. When diaphragm exercises are performed without resistance, systolic pressures drop 5 mmHg while diastolic pressures remain unchanged. The authors attribute the reductions in blood pressure to the increased parasympathetic tone associated with respiratory muscle training.

The easiest way to perform inspiratory muscle training is with a respiratory training device.This device can be purchased online for about $20. The typical strengthening routine is to perform 30 inhales at 75% full effort, six days per week for six weeks. As a rule, 75% full effort means that when you finish your final inhale, you should be moderately fatigued. Because there are so many repetitions, you can increase or decrease the resistance if the exercises are too easy or difficult simply by turning the dial. In total, diaphragm exercises take about two minutes per day to complete. As with isometric exercises, they are easy to perform and produce surprisingly good outcomes.

References:

1. World Health Organization Global Health Estimates, 2018 Report.
2. American Heart Association: Heart disease and stroke statistics-2018 update. Circulation, 2018:180.
3. Falaschetti E, Mindell J, Knott C, Poulter N. Hypertension management in England: a serial cross-sectional study from 1994 to 2011. Lancet . 2014;383:1912–1919.
4. Cornelissen VA, Fagard RH. Effects of endurance training on blood pressure, blood pressure—regulation mechanisms, and cardiovascular risk factors. Hypertension, 2005;46: 667–675.
5. Edwards, Jamie J., et al. Isometric exercise training and arterial hypertension: an updated review. Sports Medicine 54.6 (2024): 1459-1497.
6. DaSilva C. Can respiratory muscle training change the blood pressure levels and hypertension? A systemic review with meta-analysis. Scand J Med Sci Sports, Feb 25,2021.