Morning vs Evening Exercise for High Blood Pressure

Overseen By Katharine Currie, PhD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Michigan State University

Disqualifiers: Diabetes, Heart failure, Cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

79 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether exercising in the morning or evening better manages high blood pressure in postmenopausal women. Researchers are examining how exercise timing affects blood pressure and heart health. Participants will exercise either in the morning before 10:01 AM or in the evening after 3:59 PM. Women with high blood pressure who are postmenopausal may be suitable candidates, particularly if they can walk unaided and do not engage in regular physical activity. As an unphased trial, this study provides a unique opportunity to contribute to understanding how exercise timing can enhance heart health.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems likely that you can continue your medication, as the study involves exercise timing rather than medication changes.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that exercising in the morning or evening can affect blood pressure in people with hypertension. Morning exercise significantly lowers both the systolic and diastolic numbers in a blood pressure reading.

Evening exercise is also effective and might reduce blood pressure even more than morning workouts, particularly for older adults. Both morning and evening exercises are safe, with no reports of harm.

In summary, exercising at either time is safe and may effectively help manage blood pressure. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about exploring the effects of morning versus evening exercise for managing high blood pressure because it focuses on the timing of physical activity, rather than introducing a new drug or medication. Unlike standard treatments like ACE inhibitors or beta-blockers that modify blood pressure through chemical means, this approach could offer a natural and cost-effective alternative. Morning exercise may align with our body's natural circadian rhythms to optimize blood pressure control, while evening exercise might fit better into people's busy schedules, making it easier for them to stick with a routine. This trial aims to reveal whether the timing of exercise can enhance its blood pressure-lowering effects, potentially leading to more personalized and accessible lifestyle recommendations.

What evidence suggests that this trial's exercise interventions could be effective for high blood pressure?

This trial will compare the effects of morning versus evening exercise on high blood pressure. Research has shown that exercise can help lower blood pressure in individuals with hypertension. Participants in the morning exercise group will work out before 10:01 AM, as studies indicate this timing can reduce belly fat and blood pressure, benefiting heart health. Participants in the evening exercise group will work out after 3:59 PM. Other research suggests that evening workouts might lower blood pressure more immediately after exercising and have proven very effective for those with high blood pressure. Both morning and evening workouts offer benefits, but evening exercise might slightly better reduce blood pressure levels quickly. ^{4 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for postmenopausal females aged 55-80 with high blood pressure, who can walk without assistance. It's not for those who are very active, have had cancer in the last 5 years, currently smoke or vape, have certain chronic diseases like heart failure or diabetes, do evening shift work, or have a BMI over 39.

Inclusion Criteria

I am between 55 and 80 years old.

I am a woman who has gone through menopause.

Your blood pressure is too high, even with medication.

Exclusion Criteria

You regularly do at least 150 minutes of moderate exercise or 75 minutes of intense exercise each week.

You have a body mass index higher than 39.

You are currently smoking or using a vape.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in exercise training either in the morning or evening to assess effects on blood pressure and vascular health

6 weeks

Regular exercise sessions

Follow-up

Participants are monitored for changes in blood pressure and vascular health post-training

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• AM vs PM Exercise Training

Trial Overview The study tests if exercising in the morning vs early evening affects blood pressure and vascular health differently in older women with hypertension. Participants will undergo two phases of exercise training: one before and one after an observation period.

How Is the Trial Designed?

Group I: Morning (AM) Experimental Treatment 2 Interventions

Exercise starting before 10:01 AM

Group II: Evening (PM) Experimental Treatment 2 Interventions

Exercise starting after 3:59 PM

Who Is Running the Clinical Trial?

Michigan State University

Lead Sponsor

Trials

202

Recruited

687,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Published Research Related to This Trial

Intermediate chronotype adults with obesity exhibited higher blood pressure (BP) and heart rate (HR) responses during exercise compared to morning chronotype adults, indicating a potential cardiovascular risk associated with this chronotype.

However, when accounting for aerobic fitness (V̇o2max), the differences in BP responses were no longer significant, suggesting that improved fitness may mitigate these exaggerated BP responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise blood pressure and heart rate responses to graded exercise testing in intermediate versus morning chronotypes with obesity. Remchak, ME., Dosik, JK., Pappas, G., et al.[2023]

In a study of patients with established heart disease, the incidence of cardiac events during supervised exercise was low, with 5 events occurring in 168,111 patient-hours in the morning and 2 events in 84,491 patient-hours in the afternoon.

The risk of experiencing a cardiac event was not significantly different between morning and afternoon exercise sessions, suggesting that both times are safe for patients engaging in regular, submaximal exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Should patients with heart disease exercise in the morning or afternoon? Murray, PM., Herrington, DM., Pettus, CW., et al.[2004]

A systematic review and meta-analysis of 11 studies found that exercising in the morning or evening does not significantly affect systolic or diastolic blood pressure in adults.

Similarly, the timing of exercise (morning vs. evening) showed no significant impact on blood glucose levels, indicating that the time of day may not be a crucial factor for these cardiovascular risk factors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Time of the day of exercise impact on cardiovascular disease risk factors in adults: a systematic review and meta-analysis. Sevilla-Lorente, R., Carneiro-Barrera, A., Molina-Garcia, P., et al.[2023]

In hypertensive men, post-exercise hypotension (PEH) was significantly greater after evening exercise compared to morning exercise in those taking angiotensin II receptor blockers (ARB), but this effect was not observed in those taking angiotensin-converting enzyme inhibitors (ACEi).

The study found that ACEi use blunted the evening potentiation of PEH, resulting in a smaller decrease in systolic blood pressure after evening exercise compared to ARB users, indicating that the type of antihypertensive medication can influence the body's response to exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of ACEi and ARB on post-exercise hypotension induced by exercises conducted at different times of day in hypertensive men. Brito, LC., Azevêdo, L., Peçanha, T., et al.[2020]

In prehypertensive men, morning exercise led to higher heart rates throughout the day compared to a control session, indicating a potential increase in cardiovascular workload.

Evening exercise resulted in lower nighttime blood pressure and reduced cardiac work, suggesting that exercising in the evening may be beneficial for managing blood pressure levels during sleep.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Separate aftereffects of morning and evening exercise on ambulatory blood pressure in prehypertensive men. Brito, LC., Rezende, RA., Mendes, C., et al.[2018]

Evening aerobic training (ET) significantly reduced both clinic and ambulatory blood pressure in treated hypertensive men compared to morning training (MT) and a control group, indicating a greater hypotensive effect from evening exercise.

The reductions in blood pressure from ET were linked to decreased systemic vascular resistance and improved vasomotor sympathetic modulation, suggesting that the timing of exercise can influence its effectiveness in managing hypertension.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Morning versus Evening Aerobic Training Effects on Blood Pressure in Treated Hypertension. Brito, LC., Peçanha, T., Fecchio, RY., et al.[2019]

The review of studies suggests that morning exercise does not inherently increase the risk of cardiac events for cardiac patients in supervised rehabilitation programs, indicating it may be as safe as exercising in the afternoon.

However, there is a lack of comprehensive research on how the time of day affects cardiovascular responses to exercise in individuals with heart disease, highlighting the need for further studies to understand the potential risks associated with spontaneous physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chronobiological considerations for exercise and heart disease. Atkinson, G., Drust, B., George, K., et al.[2018]

Post-exercise hypotension (PEH) is more pronounced after morning aerobic exercise compared to evening sessions, with systolic blood pressure reductions of -7 mmHg in the morning versus -3 mmHg in the evening, indicating a stronger hypotensive effect in the morning.

Morning exercise leads to a decrease in cardiac output, while evening exercise increases sympathovagal balance and calf blood flow, suggesting different hemodynamic and autonomic responses based on the time of day.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Post-Exercise Hypotension and Its Mechanisms Differ after Morning and Evening Exercise: A Randomized Crossover Study. de Brito, LC., Rezende, RA., da Silva Junior, ND., et al.[2022]

A study of 2,343 Japanese male workers found that exercising in the evening (18:00-21:00) significantly lowers blood pressure compared to other times of day, suggesting optimal timing for exercise to manage hypertension.

Participants with higher blood pressure levels tended to exercise less in the evening, indicating that regular evening physical activity may be crucial for effective blood pressure control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between blood pressure and circadian timing of physical activity of Japanese workers. Imamura, M., Tahara, Y., Suiko, T., et al.[2022]

Citations

1. bjsm.bmj.com bjsm.bmj.com/content/57/20/1317

Exercise training and resting blood pressure: a large-scale ... Overall, isometric exercise training is the most effective mode in reducing both systolic and diastolic blood pressure. These findings provide a comprehensive ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/30489494/

Morning versus Evening Aerobic Training Effects on Blood ... The acute blood pressure (BP) decrease is greater after evening than morning exercise, suggesting that evening training (ET) may have a greater hypotensive ...

3. nature.com nature.com/articles/s41598-025-02659-8

Differential benefits of 12-week morning vs. evening ... Furthermore, previous studies have shown that aerobic exercise in the evening is beneficial to lowering blood pressure in hypertensive patients ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S0167494324004126

Differential effects of exercise training protocols on blood ... Exercise training significantly reduced blood pressure (i.e., SBP and DBP) in patients with hypertension. Aerobic training, resistance training, Tai chi ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6159802/

Exercise as a tool for hypertension and resistant ... Daytime systolic and diastolic ABPM decreased by 5.9±11.6 mmHg and 3.3±6.5 mmHg and nighttime systolic and diastolic ABPM decreased by 3.8±17.1 mmHg and 1.9±8.2 ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4369613/

Evidence for exercise training in the management of ... Overall, evidence suggests that dynamic resistance exercises can lower BP by a modest degree, especially in stage 1 hypertension, with no evidence of harm, ...

7. pharmacytimes.com pharmacytimes.com/view/evening-exercise-lowers-blood-pressure-more-than-morning-workouts-for-older-individuals

Evening Exercise Lowers Blood Pressure More Than ... Elderly individuals who exercise in the evening have a greater decrease in blood pressure (BP) compared with those who exercise in the morning.

8. sciencedirect.com sciencedirect.com/science/article/pii/S1440244023000427

Time of the day of exercise impact on cardiovascular ... During exercise in the early evening there was a trend to decrease for diastolic blood pressure compared to morning. But there was no difference for systolic ...

9. ahajournals.org ahajournals.org/doi/10.1161/HYP.0000000000000196

Physical Activity as a Critical Component of First-Line ... Strong evidence supports a blood pressure–lowering effect of physical activity, as determined by the 2018 Physical Activity Guidelines Advisory ...