Exercising Just Once a Week May Help Keep Blood Pressure Gains, Study Suggests

A simple exercise done at home, the wall squat, may help lower blood pressure, according to a trial published in BMJ Open Sport and Exercise Medicine. The trial found that isometric exercise, in which muscles contract without moving the joints, led to meaningful drops in resting blood pressure within just four weeks.

The study followed 100 inactive adults whose systolic blood pressure was between 120 and 140 millimetres of mercury, described in the study as normal to high-normal.

For the first four weeks, participants performed lower-body isometric wall squats at home three times a week. The routine consisted of four two-minute sessions separated by two minutes of seated rest, monitored with heart-rate straps to ensure consistent effort.

After four weeks, participants' systolic pressure fell by about 9.5 points on average. Their diastolic pressure also dropped compared with the control group, the researchers reported.

Researchers then examined what happened when exercise became less frequent. During the following four weeks, participants were randomly assigned to train three, two, one or zero times per week.

Those who stopped exercising completely saw their blood pressure return to baseline within four weeks, essentially wiping out their progress.

By contrast, participants who kept training just once or twice a week held on to a significant portion of their blood pressure reductions. Only the group that continued three times weekly retained key improvements in the following metrics.

Dr Aseem Malhotra, a cardiologist and metabolic health specialist at Ovadia Heart Health in Florida, was not involved in the study. He said that even a little of the right exercise once a week likely has demonstrable cardiovascular benefits for blood pressure, and noted that wall squats at home cost nothing.

Malhotra also said physical movement is only one piece of the puzzle. He said that in his own clinical practice he regularly sees significant improvements in blood pressure, with many patients coming off medication, from dietary change alone. In his view, a low-carb Mediterranean diet is the most substantial intervention, not just for blood pressure but for all metabolic health markers.

The researchers acknowledged the limits of their work. The cohort was relatively modest, 100 generally healthy, non-smoking adults who were not taking blood pressure medication. The findings cannot automatically be generalised to people with diagnosed hypertension, older populations with mobility limitations, or patients already on heart medication.

The maintenance phase lasted only four weeks, and the researchers noted that longer trials are needed to see whether a once-weekly session can sustain the reductions over months or years. Because the study involved physical activity, participants and researchers knew each person's assigned exercise group.