The impact of exercise on resistant hypertension: what do we know in 2025?

This review examines current evidence on the effects of physical exercise in individuals with resistant hypertension, a population for whom the effects of exercise are less well understood compared to those with general hypertension. Emerging evidence indicates that aerobic exercise promotes clinically meaningful reductions in blood pressure in individuals with resistant hypertension, with potential to reduce medication reliance and improve cardiovascular health. Combined aerobic and dynamic resistance exercise, particularly in heated-water environments, may offer additional benefits. However, important research gaps remain, including limited data on resistance training (dynamic or isometric), and mind-body exercises such as Tai Chi or Yoga. While aerobic exercise is well established as an effective strategy for lowering blood pressure, further studies are needed to evaluate other exercise modalities and digital or remote interventions to enhance adherence. Expanding the evidence base will allow for more personalized and flexible exercise prescriptions, ultimately improving long-term blood pressure control and cardiovascular outcomes in this population.