Hi, I’m Dr. Eric Cobb of Z health performance. And today we’re going to talk about using isometric exercise to lower blood pressure, part two. We did a blog on this some time ago and it was actually one of the highest performing blogs ever in our history. So apparently blood pressure is a big concern to a lot of people and they’re looking for ways to deal with it at home, not using pharmaceuticals.
So we’re going to follow up that particular blog with today’s blog. And this is based off a current study from 2023 that just came out. And it’s basically taking the implications, the clinical implications of multiple, what are called meta reviews, where we look at tons of studies and we group all the information together to examine the effects of isometric exercise on blood pressure and to give you some stats and a training program that you can use.
Now, basically, here’s what we have found, or what researchers have found. We pull all this data over thousands and thousands of individuals utilizing isometric exercise, typically between eight and twelve weeks from the time you start the program, can have a profound impact on lowering both systolic and diastolic blood pressure. On average. what they’re seeing is that after eight to twelve weeks of training, whether you’re using a hand grip exercise or using a wall sit exercise, the average reduction in systolic blood pressure is 7mm mercury, which is kind of a standard thing that we’re talking about.
So if you had blood pressure of 140 for eight weeks or so, we would expect that top number to be 133. Now, why that is important is that there have been multiple studies in the exercise world and in the pharmaceutical world looking at what does lowering blood pressure, the top number of your blood pressure, by that much. What does it mean in relationship to cardiovascular events? So what they have found is that a seven millimeter mercury decrease in systolic blood pressure over a period of years will lead to a 13% decrease in the number of heart attacks experienced and up to a 22% decrease in strokes.
So this is a really, really profoundly impactful way to deal with blood pressure in the real world. This isn’t just, hey, this is great for people that aren’t sick. This is actually used for people who may be at risk of a cardiovascular event. So how do we do it? It’s a really, really simple protocol. It’s going to take you about 24 minutes per week of work time with some rest periods built in.
So let’s talk again about the research here. Isometric exercise, if you’re unfamiliar, basically means we’re going to create a contraction without movement. So if I was using this, this is called a handheld dynamometer, I turn it on and I give a squeeze, and then I try to maintain that same amount of squeeze. I’ll get a number here or give me a readout that would be considered an isometric exercise.
So what they have found is that, in general, if we’re dealing with people who need a lower blood pressure, we need to do isometric contractions that range around 20% to 30% of what’s called the maximal voluntary contraction. So the MVC. So, for simplification sake, if I were to take this dynamometer and turn it on, I get a readout here and I squeezed it in my very maximum, ten out of ten pressure, as much as grip strength as I have. Let’s say that was 100 pounds.
To get a benefit from the isometric protocol I’m going to share with you, I would need to be averaging, during the course of the isometric contraction, 30 pounds. So basically, again, 30% of your maximum would be the very top level of contraction that we would want for any isometric exercise. Going above 30% seems to not be as beneficial and in fact, may actually be harmful to the benefit.
So we’re not trying to do something super hard here. What we want is this lower level contraction, 30%, but we need to hold it for time. So regardless, we’re talking about a hand grip exercise or a wall squat exercise where we’re doing a wall sit. We need to hold the contraction for two minutes and we’re going to do that four times. So here’s the basic protocol, and then I’m going to give you a little bit more detail.
If I’m using hand grip, I’m going to do either one hand or the other. It doesn’t really matter. You can also do it bilaterally, although there is no evidence right now that bilateral is more effective. So you can just go with whichever works better for you or what you’re more interested in. The training protocol is done three times per week. When you’re doing the protocol, you’re going to hold a contraction of roughly 30% of your maximum for two minutes.
You’re then going to stop and you’re going to rest for three minutes. And then you’re going to contract for two, rest for three, contract for two, rest for three, contract for two, and you’re done. So you’re going to do four rounds, two minutes of squeezing with a three minute rest period in between. Now, if you are deconditioned, you’re working with clients who are severely deconditioned and 30% just becomes too difficult, meaning they’re getting too fatigued, you can drop down as low as 15% and still get a profound clinical effect.
So again, if I was saying, hey, I have 100 pounds as my maximum, I could be anywhere between 15 and 30 pounds of contraction for two minutes at a time, with a three minute rest interval done three times per week. The changes in blood pressure typically initiate around four weeks after you start the training. We’ll then start to see a progressive increase in the lowering of systolic and diastolic blood pressure out to eight and twelve weeks.
And then you have to continually do the exercise, probably once or twice a week to maintain the benefit. Now, the other thing that is being looked at in the research is, is it better to do upper body, so hand grip, or is it better or more effective to do a lower body exercise which would, again, would be like a supported wall squat? So I’m against the wall and I’m just moving down into a squat position.
The challenge that we have here is that it’s harder to judge what is 30% of your maximal voluntary contraction because we don’t have any kind of device that’s helping us. However, some researchers have tried to correlate what you feel internally with what the wall squat measurement actually is in a laboratory. So what they’re finding right now is that if you are going to do a wall squat.
What you want to do is get down far enough. On a scale of one to ten, you would rate the difficulty at the end, the last 30 seconds of two minutes as a five or six. Now, most people who haven’t done a lot of conditioning work will find just being in a wall squat position for two minutes, particularly if I’m like in a chair at 90 degrees, is going to be far harder than five or six. So for people who are trying to use wall squats, the thing that we tell them in the beginning is that your very first round, you’re going to set a timer, and at one and a half minutes to two minutes of that very first round, you need to be around a five or six.
If you are higher than a five or six, you need to work your way up the wall and use less knee bend. If instead you’re, you know, you’re here. And the last 30 seconds of that first two minute round, you have an intensity of, let’s say a three, then you need to go further down so you can utilize your internal sensation and it does correlate relatively well with what we see in a lab environment where we’re actually able to put measurements to this.
Now, why would I choose upper body versus lower body? We have some options here. If you have ongoing carpal tunnel issues or upper body pain issues, holding a constrained contraction for a long time may be uncomfortable. Let’s say you have tennis elbow or golfer’s elbow. Well, that by itself may drive you to thinking, hey, the wall squat may be a better idea for me. Conversely, if you have had knee injuries or hip injuries, or you’re post surgical from a replacement trying to do something for your blood pressure, and you’re not comfortable with that sustained contraction, then obviously the upper body is available.
In both cases, we are seeing them of relatively equal effectiveness. The reason that this works is that after we begin contracting, if we’re somewhere within that 15% to 30% maximal voluntary contraction, we’ll start to disrupt blood flow to those working areas. When that happens, whenever we then release attention, there is a subsequent reflex response that will actually lower blood pressure. The issue is that we just need to do it enough and with enough intensity that we can start to create that long term change that extends beyond the actual exercising time.
The other question that often comes up when we discuss this, is people say, well, what about aerobic exercise? Isn’t that better for blood pressure? Well, the actual answer is no, not really. Maybe in some cases, yes. But in many cases, if you’re looking for the most time-efficient way to decrease blood pressure, isometrics wins. And isometric also wins for people who are potentially at risk for cardiovascular events. Because if someone, let’s say, is going to do some moderate intensity cardiovascular exercise, which is the type that is associated with positive effects on lowering blood pressure over time, what we will see is that after they finish that exercise, their blood pressure as a result of the exercise will be elevated for sometimes 30 minutes, up to several hours after they finish that training session. And again, if someone is at risk of having a stroke or something else, that extended period of elevated heart rate and elevated blood pressure can be problematic and potentially dangerous for them.
Conversely, when we do the isometric exercise, whenever we release it and we’re done, typically within about 30 seconds to a minute, your blood pressure levels will return to your pre-training level. So, in terms of safety, there is now this conversation happening in literature that, hey, we think isometrics are not only more time efficient, but they may be safer across a broader group of patients or people who are dealing with blood pressure issues.
Now, again, what we’re going for here, either for the wall squat or the hand grip. Very simple protocol. You’re gonna do it three times a week. You’re gonna do four rounds of work. Each of those four rounds will be a sustained contraction of two minutes, and you want to be somewhere between 15 and 30% of your maximal voluntary contraction. You will have to figure that out for yourself, how much you can maintain over that period of time.
Now, when you are doing your contractions, you don’t just do two minutes and then take a couple seconds off and start again with the hands. It’s two minutes rest for three minutes and repeat for the wall squat. The current suggestion is two minutes of work. So you’re squatting against the wall for two minutes. A two minute rest where you move around, relax your legs, and then you go back to it.
So really, the only difference between these two protocols is the rest period. Three minutes for the upper body, two minutes for the lower body. So this is obviously for us as brain-based practitioners, a huge deal, because we are always interested in things that can either positively or negatively influence what’s going on in the brain. Obviously, cardiovascular disease, stroke, post stroke recovery, those are all very big issues that we have to deal with as people who really focus on the neural side of things.
And we also love this recommendation because the change in blood pressure driven by the isometrics is in large part driven by neural responses to the loading that we’re creating. So for us, this fits right into the ballpark of everything that we do. The final thing I want to point out here is that these reductions, 7mm Mercury reduction in systolic blood pressure is comparable to many of the low dose medications that you would potentially be given if you were diagnosed with hypertension by your physician.
So again, if you’re looking for a tool to lower your blood pressure so that you can then have a discussion with your physician about, hey, do I need as much medication? Can I maybe start to come off of it or to replace it or to use in combination? This is the way to go based on the current literature. I know I get a lot of questions about this.
So what I’m going to do in the description below is I’m going to put a link to this current study that we’ve been referencing. I’ll also mention or put a link for the dynamometer. I don’t work with them. I don’t have an affiliate relationship. I’ll just show you which ones I use. I checked them out on Amazon this morning. I think they were $32. You don’t have to have a dynamometer for the upper body.
You can just use a tennis ball or something, but it is really useful in the beginning to figure out what that amount of pressure actually feels like and to make sure that you’re maintaining it. So if you can invest $30 to $40, I would recommend that you actually pick up in a digital dynamometer for the handwork, because I think it is motivational and it’s really helpful as you go forward.
So I hope you guys found this really useful. As I said, this is a study that is fairly recent. And I love the fact that it’s. It’s quite profound. And it looks at collection of data from so many areas, gives firm clinical guidelines for exercise professionals. And obviously, all of us have friends, family members, and maybe even ourselves and clients who are affected by blood pressure issues. And it is wonderful to have something that will take 24 minutes per week to make a really statistically significant difference in their overall health and their actual risk of having a heart attack or stroke.
So take this information, use it well, and I hope you enjoyed it. We’ll be back soon.
