Isometric handgrip exercise impacts only on very short-term blood pressure variability, but not on short-term blood pressure variability in hypertensive individuals: A randomized controlled trial

Abstract

Background: The effect of a single isometric handgrip exercise (IHG) on blood pressure (BP) variability (BPV) has not been addressed. This randomized controlled trial evaluated the effect of IHG vs. sham on BPV and BP.Methods: Hypertensive patients using up to two BP-lowering medications were randomly assigned to IHG (4 × 2 min; 30% of maximal voluntary contraction, MVC, with 1 min rest between sets, unilateral) or sham (protocol; 0.3% of MVC). Systolic and diastolic BP were assessed beat-to-beat in the laboratory before, during, and post-intervention and also using 24-h ambulatory BP monitoring (ABPM). BPV was expressed as average real variability (ARV) and standard deviation (SD).Results: Laboratory BPV, ARV and SD variability, had marked increase during the intervention, but not in the sham group, decreasing in the post-intervention recovery period. The overall change in ARV from pre- to 15 min post-intervention were 0.27 ± 0.07 (IHG) vs. 0.05 ± 0.15 (sham group), with a statistically significant p-value for interaction. Similarly, mean systolic BP increased during the intervention (IHG 165.4 ± 4.5 vs. sham 152.4 ± 3.5 mmHg; p = 0.02) as did diastolic BP (104.0 ± 2.5 vs. 90.5 ± 1.7 mmHg, respectively; p < 0.001) and decreased afterward. However, neither the short-term BPV nor BP assessed by ABPM reached statistically significant differences between groups.Conclusion: A single session of IHG reduces very short-term variability but does not affect short-term variability. IHG promotes PEH in the laboratory, but does not sustain 24-h systolic and diastolic PEH beyond the recovery period.

Inter-individual responses of post-exercise hypotension in older adults with hypertension: An exploratory analysis of different exercise modalities

“…This is a post hoc analysis of pooled randomized clinical trials (RCTs) from three previously published RCTs ( Ferrari et al, 2017 ; Schimitt et al, 2020 ; Bertoletti et al, 2022 ). These primary studies evaluated acute BP responses measured by ABPM after exercise and non-exercising control sessions.…”

“…Two studies were crossover RCTs ( Ferrari et al, 2017 ; Schimitt et al, 2020 ) and one was a parallel RCT ( Bertoletti et al, 2022 ), in which we extracted the resting and handgrip data from the same participant to maintain homogeneity in the comparisons within groups during the analysis of this exploratory study.…”

“…All experimental sessions (exercise vs. control) were performed at the same time of day ( Ferrari et al, 2017 ; Bertoletti et al, 2022 in the morning; and Schimitt et al, 2020 in the afternoon) to control for potential diurnal variation in BP and residual effects of BP-lowering medications. Before the sessions, participants were instructed to avoid physical exercise for 24 h and throughout the study.…”

“… Experimental design and protocol. (A) Ferrari et al (2017) –aerobic, combined e control sessions; (B) Schimitt et al (2020) –resistance and control sessions; (C) Bertoletti et al (2022) –isometric handgrip and control sessions. …”

“…The acute reduction on 24-h BP after exercise might vary according to different exercise modalities (aerobic exercise: −2.7/−1.3 mmHg, resistance exercise: 0.3/−0.8 mmHg, and combined: 0.5/1 mmHg for systolic and diastolic BP, respectively) ( Saco-Ledo et al, 2021 ). Our research group has investigated post-exercise hypotension after aerobic, isometric, dynamic resistance exercises, and combined aerobic and resistance exercises in older adults with hypertension ( Ferrari et al, 2017 ; Machado Filho et al, 2020 ; Schimitt et al, 2020 ; Carpes et al, 2021 ; Domingues et al, 2021 ; Bertoletti et al, 2022 ); these trials represent the average effect for group behavior. However, there is potential for inter-individual variability in BP responses ( Bouchard and Rankinen, 2001 ), which could be further explored based on whether individuals were classified as Responders (i.e., BP decreases after exercise) or Non-responders (BP does not change or increases after exercise) ( Lima et al, 2015 ; Álvarez et al, 2018 ).…”