{"id":11950,"date":"2026-09-04T06:00:11","date_gmt":"2026-09-04T05:00:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11950"},"modified":"2026-09-01T20:30:22","modified_gmt":"2026-09-01T19:30:22","slug":"exercise-and-hypertension-what-works-when-we-measure-blood-pressure-over-24-hours","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2026\/09\/04\/exercise-and-hypertension-what-works-when-we-measure-blood-pressure-over-24-hours\/","title":{"rendered":"Exercise and Hypertension: What Works When We Measure Blood Pressure Over 24 Hours?"},"content":{"rendered":"

Key words: <\/b>exercise training, ambulatory (24-h) blood pressure, hypertension<\/span><\/p>\n

This blog provides a summary of a recent <\/span>study<\/span><\/a> published in BJSM (1).\u00a0<\/span><\/p>\n

Why is this study important?\u00a0<\/b><\/p>\n

High blood pressure is the leading modifiable risk factor for cardiovascular disease worldwide.\u00a0 Exercise is a cornerstone non-pharmacological strategy for hypertension management. However,\u00a0 current evidence and meta-analyses are predominantly based on office blood pressure, an isolated\u00a0 measurement highly susceptible to measurement bias in exercise science. In contrast, 24-hour\u00a0 ambulatory blood pressure monitoring (ABPM) provides a comprehensive physiological profile\u00a0 by tracking blood pressure during daily activities and sleep, serving as a significantly stronger\u00a0 predictor of cardiovascular events and mortality. Despite the clinical superiority of ABPM for\u00a0 assessing true therapeutic efficacy, no previous study has performed a simultaneous head-to-head\u00a0 comparison of diverse exercise modalities using ABPM as the primary outcome in adults with\u00a0 systemic arterial hypertension.\u00a0<\/span><\/p>\n

How did the study go about this?\u00a0<\/b><\/p>\n

We conducted a systematic review and network meta-analysis, a statistical method that allows\u00a0 multiple treatments to be compared at once, even when they have not been tested head-to-head.\u00a0 We searched four major databases and identified 31 randomised controlled trials involving over\u00a0 1,300 adults with hypertension.\u00a0<\/span><\/p>\n

The included studies tested eight exercise modalities: aerobic training, combined aerobic and\u00a0 resistance training, high-intensity interval training (HIIT), dynamic resistance training, isometric\u00a0 training, Pilates, yoga, and recreational sports. All exercise modalities were compared with a\u00a0 non-exercise control. We used Bayesian statistical models to estimate which modalities were\u00a0 most effective for reducing 24-hour systolic and diastolic blood pressure.\u00a0<\/span><\/p>\n

What did the study find?\u00a0<\/b><\/p>\n

Three modalities significantly reduced 24-hour systolic blood pressure compared to control:\u00a0 combined training (\u22126.2 mmHg), HIIT (\u22125.7 mmHg), and aerobic training (\u22124.7 mmHg). For\u00a0 diastolic blood pressure, HIIT (\u22124.6 mmHg), Pilates (\u22124.2 mmHg), combined training (\u22123.9\u00a0 mmHg), and aerobic training (\u22122.8 mmHg) showed significant reductions. In head-to-head\u00a0 comparisons between exercise modalities, no single intervention demonstrated clear superiority,\u00a0 as inter-group differences did not reach statistical significance. Aerobic training provided the\u00a0 most robust and consistent evidence for blood pressure reduction across all ambulatory\u00a0 parameters, including 24-hour, daytime, and nighttime periods\u00a0\u00a0<\/span><\/p>\n

Notably, despite having demonstrated efficacy in studies utilizing office blood pressure, dynamic\u00a0 resistance training and isometric exercise did not yield statistically significant reductions in 24- hour ambulatory blood pressure, Non-conventional modalities such as Pilates, yoga, and\u00a0<\/span><\/p>\n

recreational sports showed promising signals, but the evidence remains limited and imprecise\u00a0 due to the small number of available trials.\u00a0\u00a0<\/span><\/p>\n

What are the key take-home points?\u00a0<\/b><\/p>\n