• Keeping blood pressure in a healthy range helps improve cardiovascular health and decreases the risk of death from certain causes like heart attack.
• A recent study found that increasing exercise-like activity, such as running or cycling, by as little as five minutes a day may help lower systolic and diastolic blood pressure.
• The results further support that longer increases in exercise-like activity could lead to clinically meaningful drops in blood pressure.

High blood pressure remains a common problem in the United States, affecting almost half the adult population. It contributes to death and increases the risk of severe problems like heart disease and stroke. Experts are interested in finding the most research-backed methods to help lower high blood pressure.

A study published in Circulation looked at the effects of different activities on blood pressure.

The researchers found that increasing exercise-like activities like running, cycling, and climbing stairs was associated with decreases in blood pressure. For example, the findings suggest that switching out 21 minutes of sedentary time with exercise-like activity could lower systolic blood pressure by about 2 mmHg.

The results highlight how much exercise can influence blood pressure and that daily changes can greatly influence cardiovascular health.

Researchers of the current study wanted to examine activity patterns in a 24-hour period and how they influenced blood pressure, both the systolic and diastolic readings. Researchers divided activity into six distinct categories:

1. Sleeping
2. Sedentary behavior
3. Standing
4. Slow walking
5. Fast Walking
6. Exercise-like activities such as cycling and running

The cross-sectional study involved data from 14,761 participants from six observational cohort studies. These studies involved participants wearing movement trackers to look at activity levels. People were eligible for analysis if they met certain criteria, like wearing the movement tracker for twenty hours or more daily and having data from at least one weekday and one weekend day.

The participants spent an average of 16 minutes a day engaged in exercise-like activities and an average of over 10 hours a day engaged in sedentary behavior. Almost one-fourth of the participants were taking medication for high blood pressure, and the average blood pressure reading was around 132/79 mmHg.

All the cohorts considered some covariates, such as alcohol intake, smoking status, and age. Some cohorts gathered data on additional covariates, like mobility and education level.

Researchers were able to conduct several analyses to examine the available data. They found that doing more exercise-like activities and sleeping were associated with lower systolic and diastolic blood pressure. In contrast, higher systolic and diastolic blood pressure were associated with higher levels of sedentary behavior.

When looking at the reallocation of activity, researchers found that replacing any other activity with exercise-like activity saw the most benefit for blood pressure. For example, researchers found that replacing five minutes of any other behavior with exercise-like activity was associated with around a 0.68-point decrease in systolic blood pressure and around a 0.54-point reduction in diastolic blood pressure.

The results also suggest that greater exercise-like activity could yield more significant reductions.

For example, researchers estimated that about a two-point drop in systolic blood pressure was associated with replacing 21 minutes of sedentary activity with exercise-like activity while leaving other activities the same. Researchers also estimated that a drop of one point in diastolic blood pressure was associated with replacing 11 minutes of sedentary time with eleven minutes of exercise-like activity.

The findings did suggest that replacing sedentary activity with other activities like walking could also help diastolic blood pressure, but that the time reallocation needed to be greater. For example, replacing 95 minutes of sedentary behavior with 95 minutes of slow walking could help lower diastolic blood pressure by one point.

In sensitivity analyses, researchers found some data that higher amounts of fast walking might actually worsen diastolic blood pressure.

Following a review of the press release, non-study author Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, noted the following about the study’s results to Medical News Today:

“This study reinforces our advice for everyone to incorporate regular exercise into their daily activity. It is encouraging to see measurable changes in blood pressure with just a few minutes of exercise, something that can be incorporated into even a busy schedule. We know that physical activity directs our organs and tissue to undergo changes that improve their performance and efficiency, which can then lead to improved blood pressure control. By increasing the intensity of exercise, you are accelerating the physiological changes that are providing for the benefits to heart health.”

The research has some limitations, particularly a lack of diversity, despite including many participants. Second, the nature of the study did not allow for long-term data collection, which could be helpful to look at in additional research.

The study cannot establish causal associations. Researchers acknowledged the possibility of misclassification, overlapping, or undetected data regarding behavior measurement. They also acknowledged that they did not directly measure activity intensity, and they were unable to examine sleep quality or how bouts of exercise affected associations. Instead, they could only examine the average time participants engaged in exercise each day.

Some of the cohort data relied on participant reporting, and some components, such as how blood pressure data was collected, varied among the cohorts.

Additionally, a subgroup analysis looking at isometric log-ratio did not observe any “interactions between sedentary behavior or exercise levels with SBP [systolic blood pressure].” This and other subgroup analyses should be considered when interpreting the study’s findings, such as those related to sleep and blood pressure.

More research may be required to understand how alterations in activities like sleep and walking can affect blood pressure.

Researchers of this study advocate for strategies that allow people to incorporate more exercise into their daily lives. This could help create meaningful changes in blood pressure. Study author Joanna M. Blodgett, PhD, noted the following in a recent press release:

“Our findings suggest that, for most people, exercise is key to reducing blood pressure, rather than less strenuous forms of movement such as walking. The good news is that whatever your physical ability, it doesn’t take long to have a positive effect on blood pressure. What’s unique about our exercise variable is that it includes all exercise-like activities, from from running for a bus or a short cycling errand, many of which can be integrated into daily routines. For those who don’t do a lot of exercise, walking did still have some positive benefits for blood pressure. But if you want to change your blood pressure, putting more demand on the cardiovascular system through exercise will have the greatest effect.”

Additionally, other actions can contribute to blood pressure control, such as reaching a healthy weight, limiting alcohol, not smoking, and managing stress levels. Throughout making lifestyle changes to improve blood pressure, people should communicate regularly with doctors and specialists as needed.

As Chen also noted, “The best forms of exercise for lowering blood pressure are those that involve aerobic activity, such as walking/jogging, bicycling, and swimming/water aerobics. It is also helpful to incorporate some strength training, as this also helps to improve the function of blood vessels and improve blood pressure…People with high blood pressure should talk to their physician about lifestyle factors that can help with blood pressure control. In general, we recommend that people eat a healthy balanced diet low in sodium, engage in regular physical activity, get an adequate amount of quality sleep, maintain a healthy weight, avoid tobacco and alcohol, and reduce sources of stress.”