Is strength training okay if you have high blood pressure?

Short answer

Yes. Regular strength training lowered resting blood pressure by about 6 (top number) and 5 (bottom number) in people with high blood pressure, as much as cardio did. But lifting very heavy weights while holding your breath pushes blood pressure above 300 for a moment, so moderate weights while breathing out work.

Is strength training okay if you have high blood pressure?
'Heavy weights → blood pressure spikes → danger' — does this formula hold?
A common belief says that with high blood pressure you should stick to cardio like walking or cycling and avoid lifting. We checked how high blood pressure goes during a lift, and what happens to resting blood pressure with regular training.
Blood pressure really spikes during a lift
Near max weight, an average of 320/250
Researchers put a tube in the arm artery of 5 people to measure blood pressure. Doing leg presses at 80–100% of their max until they couldn't lift anymore pushed it to an average of 320/250, and one exceeded 480/350. Even a small-muscle move like a one-arm curl reached 255/190.
Holding your breath was a big part
Breathing out brought 311 down to 198
10 people did leg presses at their max weight. Holding their breath tightly, blood pressure averaged 311/284, but breathing out slowly while pushing kept it at 198/175 with the same weight. At 85% of max, breathing out also kept it lower.
But with regular training, resting blood pressure fell
An analysis of 270 trials and 15,827 people
An analysis that pooled 270 randomized trials (15,827 people) found that strength training with machines or dumbbells lowered resting blood pressure by 4.55 (top) and 3.04 (bottom), similar to cardio (4.49, 2.53). Holding exercises like the 'wall sit' lowered it the most: 8.24 and 4.00.
The higher the blood pressure, the bigger the drop
About 6/5 with high blood pressure, almost 0 with normal
An analysis of 64 studies (2,344 people) found that strength training lowered blood pressure by about 6 and 5 in people with high blood pressure, about 3 and 3 in those just below that line, and barely at all in people with normal readings. Most programs used moderate weights around 60–65% of max, 3 times a week, 3 sets of 10–12 reps.
Among people with high blood pressure, as good as cardio
84 trials, 5,065 people: no difference between types
An analysis of 84 randomized trials with 5,065 people with high blood pressure found that exercise lowered blood pressure by 7.52 (top) and 4.36 (bottom). Strength training, holding exercises, cardio and mixed training did not differ in how much they lowered it.
Mixing them gave the biggest drop
Strength plus cardio lowered the top number by 12
A 2026 analysis comparing 105 randomized trials in people with high or near-high blood pressure found that mixing strength training and cardio gave the largest drop: 12.05 (top) and 6.20 (bottom). Strength training alone was relatively smaller, but every type of exercise lowered blood pressure.
Bottom line: strength training is fine with high blood pressure
The formula only holds for 'max weight while holding your breath'
Regular strength training lowered resting blood pressure in people with high blood pressure as much as cardio. Spikes happen when you lift near your max while holding your breath. Using about 60–65% of max for 10–12 reps, breathing out on the effort, and mixing in cardio works.