Exercise and Beyond for Blood Pressure

Can Yoga, Meditation, or Acupuncture Also Work?


“Patients often say, ‘I don’t like to take medications. What can I do to lower my blood pressure?’” says Robert Brook, an associate professor of medicine at the University of Michigan.

“There’s been an increasing interest in yoga, acupuncture, and other alternative ways to lower blood pressure, but no one had sifted through the data.”

So that’s what an expert panel of the American Heart Association did in a report it released in April 2013.1 To the panel, which Brook chaired, “alternative” meant measures beyond losing weight, cutting sodium, or taking prescription drugs.

Aerobic Exercise

Of all the alternatives, aerobic exercise was in a class of its own. In most of the studies that the panel reviewed, people did moderate-to-vigorous aerobic exercise for 40 minutes three to four times a week.

“We saw average reductions in systolic blood pressure of about 6 to 8 points in people with high blood pressure who were doing aerobic exercise,” says Brook. (The drop would be smaller for people who don’t have high blood pressure.)

While that’s less than the  10-to-15-point drop you’d get from medication, it’s still substantial. “It’s the type of response you’d see for a DASH low-sodium diet or weight loss,” notes Brook.

Strength Training

After aerobic exercise came exercises like weight lifting and circuit training.

“Many patients think that they shouldn’t do resistance-type exercise because there can be a short-term increase in blood pressure during the exercise,” says Brook. “But there’s also a short-term increase with aerobic exercise. We found that adding resistance exercise to aerobic led to lowering blood pressure a further 2 to 3 points.”

Slow Breathing

Also beneficial: device-guided slow breathing, which uses a machine to train people to slow down and deepen their breathing. RESPeRATE, a machine approved by the Food and Drug Administration, retails for $300 online. Slow breathing could shave 3 to 4 points off systolic blood pressure, said the heart association panel.

The evidence for other “alternative” techniques wasn’t as solid.


“Isometric exercise provided the largest reductions—10 to  12 points,” says Brook. That was in people who were doing isometric handgrip exercises for  12 to  15 minutes (in two-minute bouts) at least three times a week.

However, “far fewer studies have looked at isometric exercise, and the studies were quite small,” Brook cautions, so the results are iffy.

In a recent meta-analysis, blood pressure dropped by 5 points in people doing isometrics.2

Meditation, Yoga, Etc.

The panel gave a tentative thumbs up to Transcendental Meditation. “Studies consistently show a benefit for blood pressure lowering,” says Brook. The panel concluded that doctors “may” consider TM as a treatment for high blood pressure.

In contrast, “other meditation techniques, like Zen or mindfulness-based stress-reduction meditations, were more hit-or-miss,” says Brook.

Nor did the panel find good evidence for yoga or acupuncture, both of which it advised doctors not to consider.

“I’m not here to say that they don’t work,” says Brook. “But there are fewer published studies.”

His Bottom Line

“Aerobic exercise and strength training form the core of alternative methods of lowering blood pressure.”

And that’s not just for people who have been diagnosed with high blood pressure (who may also need drugs to lower their pressure).“Anyone with blood pressure over normal would likely benefit from these alternative therapies,” says Brook. (Normal is less than  120 over less than 80.)


Hypertension 61: 1360, 2013.
Hypertens. Res. 39: 88, 2016.

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