A weekly wall squat session can help prevent blood pressure gains from disappearing.
A study published in BMJ Open Sports and Exercise Medicine found that adults who completed four weeks of isometric exercises for the first time were able to maintain some improvements in their blood pressure with just one or two sessions per week for an additional four weeks. Those who continued to exercise three times per week had the greatest reduction and retained additional cardiovascular benefits.
Isometric exercises work muscles without moving joints through repeated movements. Holding a wall squat or plank and squeezing a handle are familiar examples.
Previous studies have reported substantial reductions in blood pressure with this type of training, sometimes comparable to or greater than those seen with some medications. The new research explored how much exercise people need to maintain these gains.
Testing How Much Exercise Is Enough
The study involved 100 adults who did not engage in structured exercise regularly. Their average age was 37.4 years, and their systolic blood pressure, the highest number in a reading, ranged from normal to high normal (120-140 mmHg). None had hypertension.
According to expert guidelines cited in the study, systolic readings of 130 to 139 mmHg are considered “high normal” and should prompt a doctor to seek medical attention regarding lifestyle changes. Participants were non-smokers, had no injuries or illnesses, and had never taken medications for hypertension. They also consumed no more than 14 units of alcohol per week (about eight standard drinks in the United States).
The researchers randomly assigned participants to a control group or one of four exercise groups. All exercise groups started with the same four-week home program: three sessions per week, each consisting of four wall squat holds separated by two minutes of seated rest.
Over the next four weeks, the exercise groups followed different schedules. One continued with three weekly sessions, two reduced their training to twice or once a week and the fourth stopped completely. Researchers assessed blood pressure, heart rate and other cardiovascular measures at baseline and after four and eight weeks.
A weekly session preserved some benefits
After the first four weeks, each exercise group showed significant reductions in systolic pressure, diastolic pressure and mean arterial pressure compared to the control group. Diastolic pressure is the lowest number in a reading, while mean arterial pressure reflects the average pressure over a heartbeat.
At week 8, the groups exercising once or twice a week still had significantly lower systolic and mean blood pressure than the control group. Neither program maintained a statistically significant difference in diastolic pressure.
Systolic pressure decreased by 6.56 mmHg from baseline in the once-weekly group and by 6.95 mmHg in the twice-weekly group. These results suggest that a reduced schedule may preserve some of the initial improvement, at least over the four weeks tested.
Participants who stopped exercising lost this benefit. Their blood pressure returned to levels that were not significantly different from those in the control group.
Three weekly sessions produced the largest decline
The group that continued to exercise three times per week experienced the greatest systolic reduction (-13.73 mmHg) from their baseline, approximately twice the decrease seen with either reduced program.
This group also maintained improvements in total peripheral resistance, a measure of the resistance blood encounters as it flows through the body’s vessels, and heart rate variability, the variation in the timing between heartbeats.
However, after the change in schedules, neither exercise group retained a statistically significant difference in diastolic pressure compared to the control group. The most sustained results therefore concerned systolic pressure and, for those who trained most often, additional cardiovascular measures.
“The study demonstrates that although low-frequency isometric exercise training may be sufficient to maintain blood pressure reductions in the short term, higher frequencies are necessary to preserve these benefits and the associated vascular and cardiac autonomic adaptations,” the researchers write.
A short study with a practical message
The results distinguish between the creation of an exercise benefit and its maintenance. All members of the exercise groups initially trained three times a week for four weeks. The study therefore cannot tell us whether doing sport only once a week from the start would offer the same benefits.
The maintenance phase also only lasted four weeks. Longer studies are needed to determine whether reduced training programs can preserve improvements for months or years.
“The study demonstrates that low-frequency isometric exercise training can help maintain short-term blood pressure reductions, providing a pragmatic option for people with limited time or compliance issues.” »
Reference: “Isometric exercise training and blood pressure control: exploring dose-response to training frequency in a randomized controlled trial” by Harry T Swift, Charles Pedlar, Damian A Coleman, John P Buckley and Jonathan D Wiles, September 29, 2026, BMJ Open Sports and Exercise Medicine.
DOI: 10.1136/bmjsem-2025-003172
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