High-intensity exercise reduces blood pressure

A British Journal of Sports Medicine review published online on May 12 found that several structured exercise programs lowered 24-hour blood pressure in adults with hypertension. Vinícius Mallmann Schneider and colleagues pooled 31 randomized trials with 1,345 participants and compared exercise approaches including aerobic training, combined aerobic-plus-resistance training and high-intensity interval training. The analysis found statistically significant reductions in 24-hour systolic blood pressure for combined training, aerobic training and high-intensity interval training versus non-exercise controls. The authors said the findings support exercise as part of hypertension care, while cautioning that some exercise categories still have limited evidence. ### Which exercise types lowered blood pressure in the review? The review found that combined training reduced 24-hour systolic blood pressure by 6.18 mm Hg, aerobic training by 4.73 mm Hg and high-intensity interval training by 5.71 mm Hg compared with control conditions. For 24-hour diastolic blood pressure, combined training lowered readings by 3.94 mm Hg, aerobic training by 2.76 mm Hg and high-intensity interval training by 4.64 mm Hg. Pilates also showed a reduction in 24-hour diastolic pressure, with a mean difference of 4.18 mm Hg, according to the paper. (bjsm.bmj.com) The authors wrote that aerobic training, whether continuous or interval-based, and combined training significantly reduced 24-hour blood pressure. They added that exercise-versus-exercise comparisons were inconclusive on whether one modality was superior to another. ### What exactly did the researchers analyze? The paper was a systematic review and network meta-analysis of randomized controlled trials in adults with hypertension. (bjsm.bmj.com) The researchers searched MEDLINE, Embase, Cochrane Central and the Regional Portal of the Virtual Health Library from November 2024 to August 2025 and included trials lasting at least four weeks. The final dataset covered 67 study arms across 31 trials. The outcome the team tracked was 24-hour ambulatory blood pressure, not just clinic readings taken at a single visit. That matters because ambulatory monitoring captures blood pressure across a full day and night, the measure used throughout this analysis. ### How strong was the evidence for high-intensity exercise? High-intensity interval training met the threshold for a statistically significant reduction in 24-hour systolic blood pressure, but the interval around that estimate was wide. (bjsm.bmj.com) The reported mean difference versus control was 5.71 mm Hg, with a 95% credible interval from 11.31 mm Hg lower to 0.002 mm Hg lower, according to the abstract. The same paper reported a 4.64 mm Hg reduction in 24-hour diastolic pressure for high-intensity interval training, with a 95% credible interval from 8.21 mm Hg lower to 0.72 mm Hg lower. The authors did not report clear superiority of high-intensity interval training over the other effective exercise modes in direct exercise-to-exercise comparisons. ### Which exercise categories still need more evidence? (bjsm.bmj.com) The authors said evidence for dynamic resistance training and isometric resistance training remained uncertain in this review of ambulatory blood pressure outcomes. They also wrote that data on non-conventional exercise modalities, including recreational sports and Pilates, were limited and imprecise for managing ambulatory blood pressure. (bjsm.bmj.com) That caveat is specific to this paper’s focus on 24-hour ambulatory blood pressure in adults with hypertension. The review did not say those activities are ineffective; it said the available data were too limited or imprecise to support firmer conclusions in this setting. That is an inference from the authors’ wording in the abstract. ### When and where can readers find the study? (bjsm.bmj.com) BJSM’s Online First page lists the paper, “Effects of different exercise training modalities on 24-hour ambulatory blood pressure in adults with hypertension: a network meta-analysis of randomised controlled trials,” under May 12, 2026. The listed authors are Vinícius Mallmann Schneider, Patrícia Klarmann Ziegelmann, Dalva Muniz Pereira and Rodrigo Ferrari. The article was accepted on March 7, 2026, according to the PDF version. (bjsm.bmj.com) The next step is likely peer dissemination rather than a new trial date in the paper itself: the study is already posted online with DOI 10.1136/bjsports-2025-111474 on the journal’s early-publication page. (bjsm.bmj.com 1) (bjsm.bmj.com 2)