Study finds high‑intensity exercise lowers blood pressure

Vinícius Mallmann Schneider and colleagues reported in the British Journal of Sports Medicine on May 3 that high-intensity interval training, or HIIT, was linked to lower 24-hour blood pressure in adults with hypertension. Their network meta-analysis pooled 31 randomized controlled trials with 1,345 participants and compared several exercise types against non-exercise controls and against one another. (bjsm.bmj.com) The paper found that combined aerobic-and-resistance training, aerobic training and HIIT all reduced 24-hour systolic blood pressure versus control. (bjsm.bmj.com) The authors said aerobic training “showed the most consistent reductions” across ambulatory blood-pressure measures taken through the day and night, while direct exercise-versus-exercise comparisons did not show a clear winner. ### How big was the blood-pressure drop in the study? The study reported that HIIT lowered 24-hour systolic blood pressure by 5.71 mm Hg compared with control, with a 95% credible interval of minus 11.31 to minus 0.002. Combined training lowered systolic pressure by 6.18 mm Hg, and aerobic training lowered it by 4.73 mm Hg. (bjsm.bmj.com) The same analysis found HIIT lowered 24-hour diastolic blood pressure by 4.64 mm Hg. Combined training lowered diastolic pressure by 3.94 mm Hg, aerobic training by 2.76 mm Hg, and pilates by 4.18 mm Hg, according to the paper. ### What kind of research was this? (bjsm.bmj.com) The British Journal of Sports Medicine paper was a systematic review and network meta-analysis, not a single new clinical trial. The researchers searched MEDLINE, Embase, Cochrane Central and the Virtual Health Library for randomized controlled trials published through August 2025. The inclusion rules required at least four weeks of structured exercise training in adults with hypertension. (bjsm.bmj.com) The trials covered aerobic exercise, resistance training, isometric exercise, HIIT, yoga or pilates, and recreational sports. ### Why did the authors focus on 24-hour blood pressure? (bjsm.bmj.com) The BMJ Group summary said the researchers centered the analysis on ambulatory blood pressure, which tracks readings during routine daily activity rather than only in a clinic. The summary said ambulatory readings are a more reliable indicator of future serious cardiovascular illness and death. (bjsm.bmj.com) The paper’s main conclusion was narrower than some headlines. The authors said aerobic training, including continuous and interval formats, and combined training significantly reduced 24-hour blood pressure, while evidence for resistance training alone remained uncertain and data on recreational sports and some non-conventional exercise were limited. (bjsm.bmj.com) ### Does this mean HIIT is now the best option for everyone with hypertension? The researchers did not say that. Their exercise-versus-exercise comparisons were “inconclusive with respect to superiority between modalities,” meaning the analysis did not establish that HIIT outperformed every other approach. (bmjgroup.com) The BMJ Group release said aerobic exercise was the form most consistently linked to significant blood-pressure reductions at any time of day. That leaves the practical message closer to adding HIIT and combined training to the evidence base, rather than replacing standard aerobic exercise. (bjsm.bmj.com) ### How does this fit with current U.S. advice? The Centers for Disease Control and Prevention says adults should get 150 minutes a week of moderate-intensity aerobic activity, or 75 minutes a week of vigorous-intensity activity, or an equivalent combination. The American Heart Association gives the same baseline recommendation and says regular exercise can help control high blood pressure. (bjsm.bmj.com) The British Journal of Sports Medicine paper does not change those guidelines on its own. The next step for readers is the same one named in current guidance: use the published study as evidence to discuss exercise type and intensity with a clinician, especially if blood pressure is already high or medication is involved. (bmjgroup.com) (bjsm.bmj.com) (cdc.gov)