Abstract
Meta-analyses have shown that supervised isometric handgrip training reduces blood pressure in hypertensives. However, the mechanism(s) underlying these effects in medicated hypertensive patients, as well as the effects from home-based exercise training, is uncertain. The purpose of this study was to compare the effects of supervised and home-based isometric handgrip training on cardiovascular parameters in medicated hypertensives. In this randomized controlled trial, 72 hypertensive individuals (38–79 years old, 70% female) were randomly assigned to three groups: home-based, supervised isometric handgrip training or control groups. Home-based and supervised isometric handgrip training was completed thrice weekly (4 × 2 min at 30% of maximal voluntary contraction, with 1-min rest between bouts, alternating the hands). Before and after 12 weeks brachial, central and ambulatory blood pressures (BP), arterial stiffness, heart rate variability, vascular function, oxidative stress and inflammation markers were obtained. No significant (p > 0.05) effect was observed for ambulatory BP, arterial stiffness, heart rate variability, vascular function and oxidative stress and inflammatory markers in all three groups. Brachial BP decreased in the supervised group (Systolic: 132 ± 4 vs. 120 ± 3 mmHg; Diastolic: 71 ± 2 vs. 66 ± 2 mmHg, p < 0.05), whereas no significant differences were observed in the home-based (Systolic: 130 ± 4 vs. 126 ± 3 mmHg; diastolic: 73 ± 3 vs. 71 ± 3 mmHg) and control groups (p > 0.05). Supervised handgrip exercise also reduced central BP systolic (120 ± 5 vs. 109 ± 5 mmHg), diastolic (73 ± 2 vs. 67 ± 2 mmHg); and mean BP (93 ± 3 vs. 84 ± 3 mmHg), whereas no significant effects were found in the home-based (Systolic: 119 ± 4 vs. 115 ± 3 mmHg; Diastolic: 74 ± 3 vs. 71 ± 3 mmHg) and control groups (p > 0.05). In conclusion, supervised, but not home-based, isometric training lowered brachial and central BP in hypertensives.
Highlights
Hypertension is a disease characterized by sustained elevations in resting blood pressure (BP) and affects more than 1 billion people (Kearney et al, 2005)
Isometric exercise was recently recommended as an adjunct treatment for hypertension by the American Heart Association and American College of Cardiology joint clincial practice guideline (Carey et al, 2018), most of the existing studies only analyzed brachial BP, limiting the understanding of the cardiovascular effects of isometric handgrip training (Farah et al, 2017a)
The main finding of this study was that 12 weeks of supervised isometric handgrip training significantly reduced brachial BP, and demonstrated for the first time that supervised isometric handgrip training decreased central systolic and mean BP in hypertensives
Summary
Hypertension is a disease characterized by sustained elevations in resting blood pressure (BP) and affects more than 1 billion people (Kearney et al, 2005). Meta-analyses have shown that isometric training, specially handgrip exercise, reducesbrachialsystolic and diastolic BPin hypertensive patients approximately 7 and 5 mmHg, respectively (Cornelissen and Smart, 2013; Carlson et al, 2014; Inder et al, 2016; Jin et al, 2017). These decreases seem to be greater than those observed after aerobic training. Isometric exercise was recently recommended as an adjunct treatment for hypertension by the American Heart Association and American College of Cardiology joint clincial practice guideline (Carey et al, 2018), most of the existing studies only analyzed brachial BP, limiting the understanding of the cardiovascular effects of isometric handgrip training (Farah et al, 2017a)
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