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Cardio, the frequent go-to for heart health, might not be the exercise king of regulating blood pressure. Exercise types that are far less aerobic, static even, have outshined it in recent studies. But what exactly is blood pressure, and why should you care about it? Every time your heart beats, your blood pressure affects your arteries. High blood pressure strains those special blood vessels. If your arteries are worse for the wear, other parts of your body pay too. Hypertension, a single word that denotes “high blood pressure,” is a leading risk factor for cardiovascular disease and chronic kidney disease, among other conditions. We measure blood pressure using two numbers, which show up as a fraction. The top number, systolic blood pressure, measures the pressure in your arteries when your heart contracts. The bottom number, diastolic blood pressure, measures the pressure in your arteries when your heart rests between contractions. What's considered “healthy” or “borderline healthy” varies slightly among guiding entities. Let's go with the American Heart Association. It classifies <120/<80 normal, 120-129/<80 elevated, 130-139/80-89 high (stage 1 hypertension) and  >140/>90 high (stage 2 hypertension). If you hit >180/>120, you're in “crisis mode” and should immediately consult a physician. It's worth looking at the AHA's chart, which is a lot easier to digest than decoding the boolean symbols you just stumbled through. Here's the scary part: Most of the time, high blood pressure offers no warning, no symptoms. On the bright side, you can stay ahead of high blood pressure because it's really easy to measure, no blood draw or complex test required. Almost any doctor's visit includes a reading, and some grocery stores have arm-cuff machines you can use for free and that track your readings over time. Or you can buy your own small, yet reliable, monitor for a price that won't break the bank. Lots of empirical evidence has shown physical activity reduces blood pressure, but recent research suggests that two types of exercise we give less thought to for blood pressure are very effective:

Stretching

In a randomized controlled trial of older adults, researchers discovered that stretching was more helpful than walking briskly for those with elevated and high blood pressure. Researchers embarked on the study not to pooh-pooh cardio's ability to control blood pressure but to see if another mode of exercise worked well too, offering “a greater number of exercise options for reducing blood pressure,” they wrote. The study played out in Canada. Forty men and women (not very many people as far as studies go) whose average age was about 62, participated. A laundry list of exclusions kept the study steady, so to speak. For example, those with diabetic conditions, kidney disorders or a host of other conditions couldn't participate. Participants either stretched or took brisk walks. Both groups did so for 30 minutes a day, five days a week, over the span of eight weeks. They were assigned randomly to one exercise mode or the other. The stretchers did 21 stretches that targeted their neck, shoulders, chest, back, hips, butt, thighs, calves — pretty much everything except the arms, as far as I can tell. They did each stretch twice and held it for 30 seconds, with 15 seconds of rest between stretches. The walkers moved at 50% to 65% of their predicted maximal heart rate (220 - their age). They strode outside on walking trails when the weather allowed and inside on treadmills when it didn’t. To keep tabs on their speed outside and adjust if needed, participants had to count their heartbeats and do some math 10 minutes in and toward the end of each session. Treadmills were an easier go because monitors measured their heart rate, and treadmill speed adjusted accordingly. All the stretch and walk sessions were supervised three days a week, and folks performed on their own the other two days. You've already read the spoiler: Stretching worked better. Researchers noted that several physiological mechanisms could be credited for stretching's ability to temper blood pressure. For example, when muscles get stretched, blood vessels get stretched too, and that may “induce structural changes within blood vessels that can affect blood vessel diameter or decrease arterial stiffness to reduce resistance to flow, which, in turn, reduces blood pressure.” They suggested adding “a comprehensive stretching routine” to aerobic exercise for “overall cardiovascular benefit.” Despite their encouraging discovery, they also said that the study’s small size was a limitation, noting that it needs to be replicated in a larger randomized controlled trial.

Isometric holds

Researchers in the United Kingdom did a meta-analysis of randomized controlled trials published between 1990 and February 2023 (a long time!) that reported reductions in blood pressure following exercise regimens that lasted at least two weeks. Ultimately, they reviewed 270 studies, which ended up including nearly 16,000 people (a lot more than the stretch study). Here's what their analysis showed regarding the effect five types of exercise had on lowering blood pressure (notice stretching isn't included, so aren't you happy you know about it too?): high-intensity interval training -4.08/-2.50 aerobic exercise -4.49/-2.53 dynamic resistance -4.55/-3.04 combined aerobic and dynamic resistance -6.04/-2.54 isometric exercise -8.24/-4.00 Isometric exercise was the clear winner in lowering both blood pressure components. And wall squats were the most effective isometric exercise. Isometric exercise, should you be unfamiliar, involves muscle contractions by way of movement that's barely perceptible to the eye. Think: holding a plank — or doing a wall squat, wherein you essentially sit in an imaginary chair, with your back against a wall. The researchers couldn't say why isometric holds were better at lowering blood pressure than the other exercise types, noting that more research is needed.

Bottom line

Many types of exercise help lower blood pressure and keep you healthy in general. There’s no need to narrow yourself to one or two, and variety in exercise is better for your overall health than doing the same type of exercise over and over. But if you have physical limitations — maybe your joints can’t handle the pressure of brisk walking — and need to tend to your blood pressure specifically, now you know research shows stretching or isometric can help.