# Blood Pressure: Water Workouts Came Out on Top in 284 Trials

_Evidence Level: Strong · Yuan Y et al., Maturitas, DOI 10.1016/j.maturitas.2026.109132_

*Optimal exercise modalities and doses for blood pressure management in adults with prehypertension and hypertension: A systematic review and Bayesian network meta-analysis.*

- **Evidence Level**: Strong
- **Why this grade**: An analysis of 284 trials with 18,750 people, all assigned by chance; the ranking of exercise types relies partly on indirect comparisons.
- **Facts**: Design: Meta-analysis · Funding: National Research Foundation of Korea; Yonsei University; Ministry of Education
- **Publication Types**: Journal Article, Review
- **Journal**: Maturitas
- **Sample Size**: 18,750 adults in 284 trials
- **Authors**: Yuan Y, Qiu B, Park Y, Li Y, Shin YH, Diao P, An SY, Jeon JY, Lee DH
- **Graded and published**: 2026-10-16
- **Last edited**: 2026-10-19
- **Topics**: Heart Health, Exercise
- **DOI**: https://doi.org/10.1016/j.maturitas.2026.109132
- **Original Source**: https://pubmed.ncbi.nlm.nih.gov/42887271/

## Summary

Ten types of exercise went head to head in one analysis. For the upper blood pressure number, exercising in water came out ahead. It lowered that number by about 10 mmHg more than in the comparison groups. For the lower number, so-called mind-body exercise, which engages body and mind together, did best. It brought the lower number down by almost 5 mmHg.

The researchers pooled 284 trials with a combined 18,750 adults. All had slightly or clearly raised blood pressure, and their average age was almost 57. In every trial, chance decided who exercised. Whole-body vibration and cycling also lowered the upper number markedly. For isometric exercise, where muscles are tensed without moving, a model estimated the largest effect at a certain weekly dose. At that dose the upper number fell by about 13.5 mmHg, though with wide uncertainty.

All ten types of exercise lowered blood pressure. The ranking, however, comes from a statistical model that links many different trials. Most comparisons between exercise types were indirect rather than tested side by side. The best dose is also a model estimate, not a tested plan. The authors see the results as a basis for exercise plans tailored to the individual.

## Practical Takeaway

In people with raised blood pressure, water-based exercise lowered the upper number by about 10 mmHg, more than other exercise types.

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_Canonical: https://longevity-germany.com/en/research/water-workouts-top-284-trials-for-lowering-systolic-pressure · Part of Longevity Cities · Updated 2026-10-19_