What if lowering your blood pressure didn’t require medication, endless cardio, or drastic lifestyle changes?

In this episode, Amy Hudson and Dr. James Fisher explore the benefits of strength training as an effective, science-backed way to reduce blood pressure. They discuss how lifting affects your heart health, the ideal training intensity for real results, and why even short, infrequent workouts can make a big difference. 

Tune in to hear how  simple, time-efficient workouts can support heart health, and why it might be the most underrated tool in your fitness routine.

• Dr. Fisher starts by tackling one of the most overlooked benefits of strength training and why it should be your go-to exercise for blood pressure reduction.
• High blood pressure is responsible for nearly 7 million deaths every year. And yet, something as simple as strength training for just 20 minutes, twice a week, can have a significant impact on bringing it down.
• Dr. Fisher breaks down a major meta-analysis involving over 2,300 people with prehypertension. Strength training was shown to be a highly effective standalone therapy for lowering blood pressure with no medication required.
• Systolic pressure is the force when your heart pumps blood, and diastolic pressure is when your heart relaxes. According to Dr. Fisher, strength training helps reduce both, which makes it a double win for your cardiovascular system.
• What the research found: Dynamic resistance training not only reduces blood pressure, it performs just as well or even better than aerobic exercise. 
• The most significant blood pressure drops come from training at moderate to vigorous intensity — about 60% of your one-rep max — proving you don’t need to go heavy to get real results.
• Dr. Fisher and Amy agree that the earlier you start strength training, the better. It creates a long-term buffer, helping you maintain healthy blood pressure levels well into your later years.
• According to Amy, if you’re already dealing with high blood pressure or prehypertension, science shows that strength training may actually help you more than traditional aerobic workouts.
• Why cardio isn’t always the answer. While cardiovascular exercise elevates your heart rate, it also raises systolic blood pressure during the workout.
• Dr. Fisher’s key exercise tip: Always remember to breathe during strength workouts. Holding your breath — even briefly — can cause your blood pressure to spike unnecessarily.
• Dr. Fisher highlights how plaque buildup and stiffening arteries make it harder for your blood vessels to respond flexibly.
• For Amy, keeping blood flowing regularly, you help your arteries retain their elasticity, which is essential for controlling blood pressure as you get older.
• Amy’s visual analogy on resistance training: Strength training is like sending out street sweepers to keep your inner blood highways clear, preventing buildup and improving how efficiently your system runs.

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SHOW TRANSCRIPT

You can almost create a buffer where you improve your blood pressure so that you can kind of carry that improvement through into your later years.

What the science is showing is that strength training is going to help you significantly.

If you engage in strength training, you’ll almost certainly improve your blood pressure.

Welcome to the Strength Changes Everything podcast, where we introduce you to the information, latest research, and tools that will enable you to live a strong, healthy life. On this podcast, we will also answer your questions about strength, health, and wellbeing. I’m Amy Hudson. I own and operate three exercise coach studios. My co-hosts are Brian Saigon, co-founder and CEO of The Exercise Coach, and Dr. James Fisher, leading researcher in evidence-based strength training. And now for today’s episode. Hi everyone. I hope you are doing well.

This is Amy Hudson and I’m here with my co-host, Dr. Fisher, Dr. James Fisher. And not only is Dr. Fisher one of the foremost researchers when it comes to evidence-based strength training, he also holds the title of Exercise Coach Chief Science Officer. And he is going to be breaking down for us in a series of podcast episodes here a little bit more about what the science has to say about the benefits that strength training offers.

You probably have heard a lot of these mentioned in the past, how strength training can benefit us in many ways physically, but this series of episodes really will help to understand what the science shows on that. When we say something is evidence-based, we’re going to break down why that is. And my hope for you as you listen to each of these brief episodes is just to be able to understand and even have that science to fall back on in terms of your conviction as to why participating in strength training may be beneficial to you, especially if some of these benefits are going to be important to you, either right now or in the future. So, how are you doing, Dr. Fisher?

I’m doing great today, Amy. Thank you. And I’m really excited to sort of present some research to the listeners about some of the data, some of the empirical studies, as you said, some of the evidence around the health benefits of strength training.

Yes, and you’re very good at it. So, let’s dive into our first one and what topic are we covering today?

Do you ask? Well, one of the key things that often goes overlooked with regards to strength training is its ability to reduce blood pressure. So most people think that they need to engage in some form of cardiovascular exercise to see blood pressure reductions. And of course, many, many people do have high blood pressure. They may go to their physician or their general practitioner and get put on blood pressure medication. And actually high blood pressure accounts for, you know, nearly 7 million deaths every year.

So the idea that we can engage in an activity, such as strength training, that can be relatively uncomplicated and brief and infrequent, you know, a couple days a week, 20 minutes or so, can reduce our blood pressure is a great thing. So I wanted to present some of the data around that so that the listeners and the audience can really kind of see where we’re coming from as academics. So I’ve got a few papers to talk through now, I guess probably the first thing to clarify is I’m going to be presenting what’s called Metro analysis. And a Metro analysis is a research paper that basically takes all of the previous research papers and binds all the data together. So it’s not just a single study with a handful of people, maybe 20 or 50 or a few hundred people. It’s all of the studies on that topic combined together with all of those participants. So for example, this first study that we’re going to look at today, Dynamic Resistance Training as Standalone Antihypertensive Lifestyle Therapy, a meta-analysis. So it’s a 2016 meta-analytic review of 64 different studies all combined for a total of 2,344 participants.

And these participants had pre-hypertension. And what that means is that their blood pressure wasn’t ideal, it was slightly elevated, but it wasn’t elevated enough to be considered hypertensive. So they didn’t have high blood pressure. And we actually can see on the screen there, have high blood pressure. I really actually can see on the screen there, if you’re watching on YouTube, you can see the title of the paper and some of the data there, but these people had a blood pressure of 127-ish over about 77, 78 millimeters of mercury. Now textbook blood pressure is 120 over 80. And I guess we should clarify what blood pressure is first and foremost. So blood pressure is the pressure of the blood against your artery walls when your heart contracts and relaxes. So you can imagine blood is being pumped around your body all the time and when your heart contracts it really pushes more blood out, so there’s a higher pressure against those arterial walls, and that’s your systolic blood pressure, that’s the first number.

And then when your heart relaxes, then the pressure isn’t as high, and that’s our diastolic blood pressure. So that’s what those two numbers mean in general. So we can see these people were pre-hypertensive, and, in this study, the authors, that I’m not gonna list all of them, but there was a number of great authors, and one of them there is Bill Kramer,

who was the head of the National Strength and Conditioning Association for a long time, so some really great names on there. And in this review, they concluded that dynamic resistance training elicits blood pressure reductions comparable to or greater than those reportedly achieved with aerobic exercise training. So I think this is really important that we start to recognize that resistance training can be as effective, potentially even better, than traditional cardiovascular or aerobic training, which might take a lot longer if people are going for a run or a swim or a cycle or so forth. So there’s a second paper here that I’m just going to jump straight into if that’s okay Amy and this was actually with hypertensive participants so strength training for arterial hypertension treatment and again another systematic review and meta-analysis. So this time it was a combination of 14 studies and a total of 253 participants and this time they were hypertensive so they did have they were diagnosed with high blood pressure and they were presumably on some form of medication. The conclusions from following strength training studies and of course the 14 studies will be of different durations some might be 20 weeks and some will be a low volume approach. So there’s kind of a range of different variables within those strength training studies that’s maybe worth clarifying. And what they concluded at the end of the meta-analysis from all these strength training studies was that systolic and diastolic blood pressure decreased significantly after strength training. And they even went so far as to say that the largest effects were observed in protocols with a moderate to vigorous load.

And they sort of said that was about 60% of one rep max. Now, what that really means for many people listening is that these clients worked relatively hard. They didn’t work maximal, they didn’t lift the heaviest weight they could lift for a single repetition, but they did work relatively hard. They didn’t work maximal, they didn’t lift the heaviest weight they could lift for a single repetition, but they did work relatively hard. And I think that’s the important part.

We’ve talked about effort as a parameter within strength training before. So once again, that’s showing as being one of the more important variables. And if we start to look at some of the figures, I’ve put the figures up on the screen here for people who might be watching on YouTube. So we’ve got our 18 to 50 year olds is the top category and our 51 to 70 year olds is the lower category. And they actually broke the data down here. And this is really nice because one of the things that it shows is that the 18 to 50 year olds improved their systolic blood pressure to a greater degree actually than the 51 to 70 year olds. Now that’s not to say that if you’re over 50 years old or over 51 you can’t improve your blood pressure by strength training because you absolutely can but what this is saying is by engaging in strength training that bit earlier you can make that bit greater improvement and as we’ve talked about with so many other variables you can almost create a buffer where you improve your blood pressure to a greater degree when you’re younger so that you can kind of carry that improvement through into your later years. And the second figure on the screen now is our diastolic blood pressure, so that’s the pressure against the pressure of the blood against the arterial walls when the heart relaxes. Or we can see basically the same thing. There were improvements for both age groups, but there was a greater improvement for the 18 to 50 year old participants compared to the 51 to 70 year old participants. Any thoughts on those studies, Amy?

Well, so a couple of things that I noticed is that, well, first of all, meta-analyses. This isn’t one study that has a goal to show one outcome. Whenever we talk about research or studies, we have to be careful when we cite things that we don’t quote one study that was funded by a certain organization that has a goal of showing one thing. This is across the board of many different types of studies showing that, you know, resistance strength training can help decrease both systolic and diastolic blood pressure across participants of any age, which is pretty exciting. A couple questions for you. First of all, do you know what these studies, you know, the duration of how long these people strength train for before they got retested or was it immediately after a strength training session that their blood pressure dropped?

Yeah, that’s a great question. And to be honest, Amy, you’ve caught me out. I should really know the answer to that. But what they typically do with this kind of study, with any kind of intervention study like this, is they will recruit the participants. So they may have been recruited from a clinic. Each individual study will have had its own specific criteria. But presumably, let’s take a prehypertensive one first. The study recruited participants that were prehypertensive, so they may have been referred to the study by a physician or recruited from a laboratory within a university or a medical facility of some kind. Their blood pressure and other parameters will have been measured, their height, their body mass, maybe their strength and things like that. And then they went through a strength training intervention. And of course it depends on the researchers how long that intervention was and the format of that intervention. We’ve talked previously that many people do use just purely resistance machines, other people would use free weights or body weight exercise. So there was probably a broad spectrum of modalities of strength training. There was probably also a range of durations of the intervention, whether that was eight weeks to 20 weeks. Some strength training studies even go to sort of six months or even a year, not very many strength training studies in that long. So we can probably be relatively confident it was between eight and twenty weeks and then they would have reassessed blood pressure after that. Now what most of those studies would also have done is they would have asked people to control all the other variables. So they would have said to people, you know, don’t go away and change your diet, don’t go away and start doing loads of other cardiovascular exercises as well, just engage in the strength training that we’re prescribing. And they will probably supervise strength training as most strength training studies are. So maybe these people went to a lab once or twice a week or three times a week and they engaged in strength training with the researchers and then they had their blood pressure measured afterwards. So it’s a relatively simple process and protocol but as you said it’s a meta-analysis, it’s not just a single study. You know, many researchers, myself included, have done these individual studies and try to recruit, you know, relatively large samples or found some interesting data.

But one of the things that’s really important is that other labs then go away and kind of do what’s called a replication study. They say, Oh, well, so-and-so found that strength training, reduced blood pressure, let’s see if it is the same for our population group, or let’s see if it’s the same in our laboratory. And hence, we end up with a meta-analysis of somewhere between 20 and 50 or more studies with instead of 20 or 50 or 100 participants, you know, 2000 plus participants. And at that stage, we can start to then be confident that any change that we see is really a true change that would be impactful for the population, not just impactful at a research level, you know, many studies, uh, it’s hard to say, well, look, these 20 people improve their blood pressure and then expect the rest of the population to go away and do it. Actually, when we’ve got thousands of people who are improving their blood pressure, we can be pretty confident as academics and as researchers to say, hey, if you engage in strength training, you’ll almost certainly improve your blood pressure.

Yes, and the other thing I want people to catch on this is if you have high blood pressure or you’re prehypertensive and your doctor recommends that you start engaging an exercise to help you combat that high blood pressure, or just as a healthier habit to kind of address this issue, what the science is showing is that strength training is going to help you significantly more than aerobic activity.

Would that be fair to say? Right. Yeah, I think that would be fair to say. Yeah, I think many people are scared of engaging in strength training for blood pressure related kind of conditions, partly because there’s an assumption that strength training increases blood pressure and actually in the short term there may be some elevation in your systolic blood pressure, but almost certainly no different from what you would see if you engage in any exercise and any exercise that elevates your heart rate. So cardiovascular exercise, which would elevate your heart rate, would also increase your systolic blood pressure. Now the other thing that people are fearful of in strength training is if people are pressing so hard against something that they will hold their breath and press as hard as they can. And it’s called the Valsalva maneuver. And actually there is evidence to show that if you do that, then your blood pressure will drop quite quickly because you’re holding your breath and contracting the blood vessels and not allowing that venous return, the blood to return to your heart and then when you relax the blood pressure will go up again, will spike again. But obviously most people listening to this are well aware that the coach is certainly the exercise coach and hopefully everybody listening to this who’s engaging in strength training in whatever format knows that when you engage in strength training you should be breathing. You should never be holding your breath and exhaling and forming a valve salvo maneuver. So, uh, and if you’re doing that, then you’re avoiding that drop in that spike in blood pressure and you’re absolutely going to see the improvements that the research studies have supported.

Great.

Okay. And I have one final question about this and then, and you may be about to address this, so forgive me if you were. What is the mechanism by which strength training helps to reduce blood pressure?

I mean, is it the workout itself? Is it the effort that we’re giving during a session? Is it getting stronger? How does getting stronger or participating in strength training, what’s going on in the body that helps that to reduce the blood pressure?

Yeah, absolutely. Okay. So one of the reasons that we see elevated blood pressure is potentially a narrowing of the arteries, which is a buildup of kind of plaques inside the arteries or a stiffening of the arteries with age. So as we age there is just a general degree of general loss of the degree of elasticity. Well of course if we’re exercising or we’re making blood pump through then we’re trying to retain that elasticity because our arteries have to react to that response. So of course with strength training and with cardiovascular exercise, we are seeing that kind of higher flow of blood from our heart to get oxygen around to the working muscles. We also know that strength training can reduce body fat and improve body composition. So it’s hypothesized that improvements in body composition can lead to improvements in blood pressure.

And there’s also the idea that we are improving our capillarization. So we’re actually able to improve the way that blood flows around our body just simply by engaging with high effort exercise. So the idea that there’s only one mechanism at play here is a little bit blink and actually there’s multiple things that are happening that are helping us to respond to positively respond to this exercise format to improve our pressure.

Okay well thank you for breaking that down that helps me understand i picture like the street sweepers or the street washers in those trucks that go down the road and they clean the edges of the road. It’s kind of like when you’re getting healthier and you’re improving your body composition and participating in exercise, it’s like you’re sending the street sweepers down to keep those highways and byways clear.

I like that analogy. I like that analogy.

Well, and so what else do you have on this topic for us or was that the main crux of the research that you’d want to share with us today on this?

Yeah.

Yeah.

That’s what I’ve prepared today. And I think, you know, there’s a number of studies that we could get into. We could certainly go into the individual studies themselves, but actually looking at the meta-analyses in this case, just can be a really nice way to say, here’s an overview of the topic. So that’s what I’ve got for the listeners today.

Great.

Well, thank you so much. This helps if you’re concerned about high blood pressure, if you have a relative that’s hypertensive, please do send them or consider sending them this episode. It doesn’t take that long to participate in strength training, even as Dr. Fisher mentioned, 8 to 12 weeks or up to even a year. That can be a significant change though for somebody’s future trajectory in health.

And so let’s participate in this and understand that this is one of the many exciting benefits that strength training delivers. Thank you for breaking this down for us, Dr. Fisher. We’ll see you guys next week on the podcast. And always remember, strength changes delivers. Thank you for breaking this down for us, Dr. Fisher. We’ll see you guys next week on the podcast and always remember, strength changes everything. Thanks for listening.

If you enjoyed today’s episode, please share it with a friend. You can submit a question or connect with the show at strengthchangeseverything.com. Join us next week for another episode and be sure to follow the show on Apple Podcasts,

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