Can wall squats and planks lower your blood pressure?

Recent headlines have claimed that isometric exercises, such as wall squats and planks, are best for lowering blood pressure. Is this true? We go behind the headlines.

New research published in the British Journal of Sports Medicine suggests that isometric exercises are better than other forms of exercise at lowering blood pressure. Isometric exercises, such as wall squats and planks, involve holding your body still while tensing your muscles for set periods of time.

This study was a systematic review, which means the researchers combined the results of several trials instead of doing any new experiments.

They looked at 270 trials carried out around the world between 1990 and 2023. In total, this included almost 16,000 participants both with and without health conditions. The researchers compared how much people’s resting blood pressure dropped after following one of five different categories of exercise programme:

• Aerobic exercise, such as cycling, walking and jogging
• Resistance training, such as lifting weights
• Combined training (weights and aerobic exercise)
• High-intensity interval training (HIIT), such as sprint intervals
• Isometric exercises, such as wall squats.

While all five programmes reduced blood pressure, isometric exercises were the most effective, followed by combined training, resistance training, aerobic exercise, and HIIT.

The study also compared specific exercises, showing that walking was less effective at lowering blood pressure than cycling or running. And still, these forms of ‘cardio’ were less effective than isometric wall squats.

In fact, wall squats (or ‘wall sits’), which involve propping yourself up against a wall with your thighs parallel to the ground, were the most effective exercise out of all those compared.

What do the researchers say?

When it comes to exercise, the current NHS recommendations for managing high blood pressure only talk about aerobic exercise, or ‘cardio’. They recommend at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week, such as cycling and fast walking.

Although these traditional forms of cardio have been tried and tested, other types of exercise may be effective too, so the researchers want their analysis to influence future guidelines on blood pressure management.

Jamie O’Driscoll, a reader in cardiovascular physiology at Canterbury Christ Church university and senior author of the report, told the BBC that isometric exercises place a very different stress on the body to aerobic exercise.

He said: “They increase the tension in the muscles when held for two minutes, then cause a sudden rush of blood when you relax. This increases the blood flow, but you must remember to breathe."

This could be how isometric exercises work to improve blood pressure. But remember, all exercise categories included in the study were effective. This means that if you already have an established walking routine, for instance, you may not need to change your workouts. While you might consider trying new types of exercise, in the long-run, you’re more likely to stick to an exercise programme you enjoy.

The BHF verdict

Joanne Whitmore, Senior Cardiac Nurse at the BHF said: “Exercise is good for your heart health and health in general. It can reduce the risk of heart and circulatory diseases by up to a third. Aerobic exercise in particular can help the heart and circulatory system work better through lowering blood pressure. Current guidelines also encourage muscle strengthening exercises, like yoga or Pilates.

It's encouraging to see other forms of exercise explored in this research as we know that those who take on exercise they enjoy, tend to carry on for longer, which is key in maintaining lower blood pressure. However, there are other lifestyle choices that can benefit your blood pressure. These include keeping to a healthy weight, eating a balanced diet, cutting down on salt, not drinking too much alcohol and taking any prescribed medication.

If you have a heart condition, please consult with your healthcare practitioner about the type of exercise best suited to you and your condition.”

How good was the research?

This research used two related methods called systematic review and meta-analysis. In systematic reviews, several studies are selected and evaluated in a structured way. Meta-analysis is the statistical method used to give an 'average' of the findings from these studies, which is considered high-quality evidence.

The main strength of this study was its size and scope, given that it included many studies with varied populations. The researchers excluded studies where factors other than exercise, e.g. medication, may have influenced blood pressure. The study also looked at the effectiveness of specific exercises like walking, cycling, and wall squat, among others.

But the study also had certain limitations. Systematic reviews are only as credible as the studies they are based on. In this case, the studies differed from each other quite a lot, so it wasn’t easy to compare them like-for-like. Also, despite their promising results, isometric exercise studies were few. A greater number of studies looked at recommended exercise programmes such as cardio and resistance training.

How good was the media coverage?

This research was covered by several newspapers, including The Guardian, The Daily Mail and Sky News.

The coverage was largely accurate, reporting that isometric exercises were better for blood pressure than other exercise types. For instance, The Guardian headline was: “Planks and wall sits best exercise for lowering blood pressure, study says”.

But it’s worth noting that planks weren’t specifically mentioned in this research. The isometric exercise studies included in the review experimented with wall squats, hand grips and leg extensions.

The Daily Mail headline was: “Got high blood pressure? Why doing the plank or 'wall-sits' might be better than going for a swim”. In this case, it would have been more accurate to swap swimming for walking, cycling or running, as the researchers didn’t run any analysis on swimming.

Although isometric exercises were most effective overall, bear in mind that all exercise programmes led to improved blood pressure. Don’t let the headlines put you off cardio if you can’t safely carry out planks, wall squats or other isometric exercises.

What to read next...