A weekly wall-squat session may help keep blood pressure gains from slipping away.
A study published in BMJ Open Sport & Exercise Medicine found that adults who first completed four weeks of isometric exercise could retain some blood pressure improvements with just one or two sessions a week for another four weeks. Those who continued training three times weekly achieved the largest reduction and preserved additional cardiovascular benefits.
Isometric exercises work muscles without moving the joints through repeated motions. Holding a wall squat or plank and squeezing a handgrip are familiar examples.
Earlier studies have reported substantial blood pressure reductions with this type of training, sometimes comparable to or greater than those seen with certain medications. The new research explored how much exercise people need to keep those gains.
Testing How Much Exercise Is Enough
The study involved 100 adults who did not regularly do structured exercise. Their average age was 37.4, and their systolic blood pressure, the upper number in a reading, ranged from normal to high-normal (120-140 mmHg). None had hypertension.
Under the expert guidelines cited in the study, systolic readings of 130 to 139 mmHg are considered “high-normal” and should prompt medical advice about lifestyle changes. Participants were nonsmokers, had no injuries or illnesses, and had never taken blood pressure medication. They also consumed no more than 14 units of alcohol weekly (about eight U.S. standard drinks).
Researchers randomly assigned participants to a control group or one of four exercise groups. All exercise groups began with the same four-week home program: three sessions a week, each consisting of four wall-squat holds separated by two minutes of seated rest.
During 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 entirely. Researchers assessed blood pressure, heart rate, and other cardiovascular measures at the start and after four and eight weeks.
One Weekly Session Preserved Some Benefits
After the first four weeks, every exercise group showed significant reductions in systolic pressure, diastolic pressure, and mean arterial pressure compared with the control group. Diastolic pressure is the lower number in a reading, while mean arterial pressure reflects average pressure across a heartbeat.
By week eight, the groups exercising once or twice weekly still had significantly lower systolic and mean arterial pressure than the control group. Neither schedule maintained a statistically significant difference in diastolic pressure.
Systolic pressure fell by 6.56 mmHg from baseline in the once-weekly group and 6.95 mmHg in the twice-weekly group. These results suggest that a reduced schedule can preserve some of the initial improvement, at least over the four weeks tested.
Participants who stopped exercising lost that advantage. Their blood pressure returned to levels that were not significantly different from those in the control group.
Three Weekly Sessions Produced the Largest Drop
The group that continued training three times a week recorded the largest systolic reduction (-13.73 mmHg) from its starting level, roughly twice the decrease seen with either reduced schedule.
That 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 timing between heartbeats.
However, after the schedules changed, none of the exercise groups retained a statistically significant difference in diastolic pressure compared with the control group. The strongest sustained findings therefore concerned systolic pressure and, for those training most often, additional cardiovascular measures.
“The study demonstrates that while lower frequency isometric exercise training may be sufficient to maintain blood pressure reductions over the short term, higher frequencies are required to preserve these benefits and the associated vascular and cardiac autonomic adaptations,” the researchers write.
A Short Study With A Practical Message
The findings distinguish building an exercise benefit from maintaining it. Everyone in the exercise groups first trained three times a week for four weeks. The study therefore cannot tell us whether exercising just once a week from the beginning would offer the same benefits
The maintenance phase also lasted just four weeks. Longer studies are needed to determine whether reduced training schedules can preserve improvements for months or years.
“The study offers evidence that lower frequency isometric exercise training can help maintain short-term blood pressure reductions, providing a pragmatic option for individuals with limited time or adherence challenges.”
Reference: “Isometric exercise training and blood pressure control: exploring the dose-response to training frequency in a randomised controlled trial” by Harry T Swift, Charles Pedlar, Damian A Coleman, John P Buckley and Jonathan D Wiles, 29 September 2026, BMJ Open Sport & Exercise Medicine.
DOI: 10.1136/bmjsem-2025-003172
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