Regular cardio shaves 4.7 mmHg off blood pressure, and more volume helps

Aerobic exercise is one of the standard lifestyle measures for keeping blood pressure in a healthy range, but most trial evidence has been generated in Western populations. Whether the same effects, and the same exercise doses, apply to East Asian adults has been less clearly quantified. This meta-analysis set out to answer that directly: how much does regular aerobic exercise lower resting blood pressure in healthy East Asians, and what pattern of exercise produces the biggest change? The dose question matters as much as the headline effect, because it shapes how people plan a week of training.

The authors pooled randomised controlled trials in healthy East Asian adults in which an exercise group performed regular aerobic exercise and a control group did not, with resting systolic or diastolic blood pressure reported. In total, 31 study groups covering 1994 participants met the inclusion criteria. Beyond the overall pooled effect, they ran subgroup analyses comparing trials whose programmes met the American Heart Association and American College of Sports Medicine physical activity guidelines against trials that fell short. They also used meta-regression to test which features of the exercise dose tracked with larger blood pressure changes.

Regular aerobic exercise lowered resting systolic blood pressure by an average of 4.7 mmHg and diastolic pressure by 3.2 mmHg compared with not exercising. The systolic reduction was significantly larger in trials whose programmes met the AHA and ACSM activity guidelines than in those that did not. The regression analysis pointed to the product of exercise time and exercise frequency as the factor tied to systolic change, in other words longer sessions done more often. The authors conclude that the ideal volume matches the guideline recommendation: moderate intensity exercise for more than 150 minutes per week.

The result lines up with the broader trial literature showing aerobic exercise reliably lowers resting blood pressure, and extends it by confirming and sizing the effect in East Asian adults specifically. It also sharpens the dose question: total weekly volume, the combination of session length and frequency, appeared to be the lever that mattered. What pooled averages cannot reveal is how any one individual will respond. And because these trials enrolled healthy adults, the findings do not directly describe people already managing diagnosed hypertension.

The useful part for a reader is the shape of the dose. Programmes that reached guideline volumes, moderate intensity for more than 150 minutes a week, produced larger systolic reductions than lighter programmes, and the analysis tied the effect to time multiplied by frequency. That is a reason to think of consistent, accumulating weekly cardio, rather than the occasional hard session, as the version of exercise that moves blood pressure. This is information about averages in healthy adults, not a treatment plan for anyone with a diagnosis.