Which Exercise Lowers Blood Pressure Best? Aerobic Beats Weights for Hypertension

Want to manage high blood pressure better? New research published this week serves a clear message: aerobic exercise takes the lead over resistance training for lowering blood pressure in people with hypertension.

What Did the Researchers Want to Know?

Hypertension, aka high blood pressure, is a global health headache affecting over 1.2 billion adults worldwide. Exercise is often recommended for tackling it, but what’s the most effective type? This meta-analysis dug into the question:

Which exercise modality — aerobic training (endurance activities like walking, cycling), resistance training (weight-bearing exercises), or a combination of both — works best for lowering blood pressure, improving heart and lung fitness (measured by VO2max), and reducing resting heart rate in adults with hypertension?

How Did They Study This?

The researchers pooled randomized controlled trials (RCTs) published over the last decade (2014–2025), focusing only on adults diagnosed with hypertension who participated in an exercise programme for at least 8 weeks. They found 7 relevant studies involving 410 participants. Here’s what makes it simple:

Aerobic training (AT): Continuous, rhythmic activities like jogging or cycling.
Resistance training (RT): Weight lifting or muscle-strengthening exercises.
Combination training (CT): A mix of both AT and RT in the same programme.

They analysed changes in systolic and diastolic blood pressures, cardiorespiratory fitness (VO2max), resting heart rate (RHR), and endothelial function (how flexible the blood vessels are).

What Did They Find?

Aerobic training outperformed resistance training: AT led to significantly greater reductions in overall blood pressure (a combined measure of systolic and diastolic levels), better improvements in VO2max (the gold standard for how well your heart and lungs deliver oxygen), and lowered resting heart rate more effectively.
Combination training shows promise: Although with fewer studies, CT seemed to reduce blood pressure even more than RT and potentially better than AT, especially for diastolic pressure, but these results are preliminary and should be interpreted with caution.

Details from their pooled data:

Blood pressure: Overall drop favored AT over RT (SMD -2.55; p=0.04)
VO2max and RHR: Significant improvements with AT vs RT (p < 0.001)
CT vs RT showed significant blood pressure reductions, but more research is needed.

Why This Matters for Your Workout

If you have high blood pressure or are worried about it, it’s reassuring to know that lacing up your trainers for aerobic exercise can produce measurable health benefits, including lowering blood pressure and improving your heart and lung fitness.

Some actionable tips:

Prioritise aerobic exercises like brisk walking, jogging, cycling, or swimming for at least 8 weeks.
Aim for consistent sessions during the week rather than sporadic workouts.
Consider adding resistance training too, but if blood pressure is your main concern, aerobic training should come first.
Combination training might be even better, but we need more robust research for a solid recommendation.

What Does This Study Add to the Conversation?

This meta-analysis is one of the first to rigorously compare aerobic, resistance, and combination training head-to-head in hypertensive adults, focusing not only on blood pressure but also cardiorespiratory fitness and resting heart rate. It confirms aerobic training’s leading role but points to combination training as an intriguing future avenue.

It also addresses the messy variability in past studies, showing while results differ from person to person and study to study (high heterogeneity), the overall pattern favours aerobic exercise.

Unanswered questions:

What’s the best "dose" and intensity of aerobic exercise specifically for blood pressure control?
Can combination training synergistically boost benefits reliably across different groups?
How do individual factors like medication, age, or severity of hypertension influence these effects?

The Bottom Line

Aerobic exercise stands out as the most effective way to manage blood pressure and improve heart and lung fitness in hypertensive adults. Weights and resistance work have their place but might not be the best standalone option for lowering blood pressure. Combination training could be a game-changer, but that’s an open field.