Isometric Resistance Training to Manage Hypertension: Systematic Review and Meta-analysis

Abstract

Purpose of Review Hypertension is the primary risk factor for cardiovascular disease and adequate blood pressure control is often elusive. The objective of this work was to conduct a meta-analysis of trial data of isometric resistance training (IRT) studies in people with hypertension, to establish if IRT produced an anti-hypertensive effect. A database search (PubMed, CINAHL, Cochrane Central Register of Controlled Trials, and MEDLINE) identified randomised controlled and crossover trials of IRT versus a sedentary or sham control group in adults with hypertension. Recent Findings We included 12 studies (14 intervention groups) in the meta-analyses, with an aggregate of 415 participants. IRT reduced systolic blood pressure (SBP), mean difference (MD) − 7.47 mmHg (95%CI − 10.10, − 4.84), P < 0.01; diastolic blood pressure (DBP) MD − 3.17 mmHg (95%CI − 5.29, − 1.04), P < 0.01; and mean arterial blood pressure (MAP) MD − 7.19 mmHg (95%CI − 9.06, − 5.32), P < 0.0001. Office pulse pressure and resting heart rate was not significantly reduced, neither were 24-h or day-time ambulatory blood pressures (SBP, DBP). Night-time blood pressures, however, were significantly reduced with SBP MD − 4.28 mmHg (95%CI − 7.88, − 0.67), P = 0.02, and DBP MD − 2.22 mmHg (95%CI − 3.55, − 0.88), P < 0.01. Summary IRT does lower SBP, DBP and MAP office and night-time ambulatory SBP and DBP, but not 24-h mean ambulatory blood pressures in people with hypertension.

Is isometric exercise training the best FIT for exercise prescription in the prevention and treatment of arterial hypertension?

“…Strong evidence exists that the greatest exercise induced BP reductions are seen in those with the highest resting BP levels 5 6 9. In a recent meta-analysis, even though IRT was shown to substantially lower systolic and diastolic office-time and night-time ambulatory BP, there was no evidence for a reduction in mean ambulatory systolic and diastolic BP values in patients with hypertension (n=4 studies) 10…”

The Role of Exercise in the Treatment of Hypertension: Traditional Review

“…İzometrik direnç egzersizi; ilgili kas grubunun uzunluğunda hiçbir değişiklik olmadan veya minimum değişiklik ile hareketsiz bir yüke veya dirence karşı kasların sürekli kasılmasıyla gerçekleştirilen bir egzersizdir. 20,21 HT'li bireylerde izometrik direnç egzersiz çalışmaları incelendiğinde, çoğu egzersiz olarak yalnızca küçük bir kas grubunu çalıştıran ve kısa bir sürede (<15 dk) gerçekleştirilen izometrik elkavrama kasılmasını kullanmıştır. Elle sıkma egzersizinin brakiyal arteri tamamen veya kısmen tıkadığı, sıkmanın kesilmesiyle geri dönen kan akışının damarın dilatasyonuna neden olduğu varsayılmaktadır.…”

“…Bu nedenle izometrik direnç egzersizine aşamalı olarak maruz kalmak vazodilatör yanıtı ve zamanla damar çapını artırabilir. 21 Uzun vadede verilen diğer yanıtlar ise doku oksidatif stres düzeyinde azalma, vasküler endotelyal fonksiyonda iyileşme, barorefleks duyarlılığında ve otonomik dengede olumlu değişikliklerdir. 51,52 Carlson ve ark., 9 çalışmayı içeren (metaanalize dâhil edilen çalışmalardan üçü hipertansif hastaları incelerken, diğerleri normotansif bireyleri içermektedir) metaanalizinde, en az 4 hafta boyunca haftada 1 saatten fazla yapılan izometrik direnç egzersizinin ofis SKB'yi 6,77 mmHg ve DKB'yi 3,96 mmHg azalttığı sonucuna varmıştır.…”

“…Bununla birlikte izometrik direnç egzersizinin kalp hızını ve 24 saatlik ortalama AKB, SKB ve DKB'lerini önemli ölçüde azaltmadığı rapor edilmiştir. 21 53 Son zamanlarda 2020 ESC kılavuzunda, HT'si olan hastalarda ilk kez izometrik direnç egzersizinin KB'yi azaltma potansiyelinden bahsedilmiştir. 54…”

Taoist way of a balanced exercise training cocktail for the management of primary hypertension in older persons

“…Question 1: Which type of exercise training is better in terms of BP control? When combined with hypertension medication, aerobic exercise could significantly reduce daytime systolic and diastolic BP by −5 and −3.5 mmHg, respectively ( 31 ); resistance exercise could significantly reduce daytime systolic and diastolic BP by −4.7 and −3.5 mmHg, respectively ( 32 ); and isometric resistance exercise could significantly reduce daytime systolic and diastolic BP by −7.5 and −3.2 mmHg, respectively ( 33 ). Since previous meta-analyses of multi-component exercise training for the treatment of hypertension only covered a small amount of the available literature ( n = 2) ( 31 ) or examined its effect on systolic BP only ( 34 ), we conducted an updated one ( n = 7) and present the results here (see also the Supplementary Material for detailed methods: https://doi.org/10.6084/m9.figshare.24247861.v1 ).…”