Aerobic versus isometric handgrip exercise in hypertension

Pagonas, Nikolaos; Vlatsas, Stergios; Bauer, Frederic; Seibert, Felix S.; Zidek, Walter; Babel, Nina; Westhoff, Timm H.

doi:10.1097/hjh.0000000000001445

Cited by 52 publications

(75 citation statements)

References 29 publications

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“…Similarly, Stiller-Moldovan et al (2012) did not observe reduced ambulatory BP after 8 weeks of supervised isometric handgrip training in medicated hypertensive participants. Recently, Pagonas et al (2017) also did not observe reductions in ambulatory BP after supervised in hypertensive individuals. Previous studies have shown that ambulatory BP is a better marker of cardiovascular risk than office BPs (brachial or central BP) ( Huang et al, 2011 ).…”

Section: Discussionmentioning

confidence: 93%

Supervised, but Not Home-Based, Isometric Training Improves Brachial and Central Blood Pressure in Medicated Hypertensive Patients: A Randomized Controlled Trial

et al. 2018

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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.

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Section: Discussionmentioning

confidence: 93%

Supervised, but Not Home-Based, Isometric Training Improves Brachial and Central Blood Pressure in Medicated Hypertensive Patients: A Randomized Controlled Trial

et al. 2018

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“…As published previously, the study size was calculated by the expected effect of exercise on BP (reduction of about 7 mmHg of the systolic BP) resulting in the recruitment of 75 patients. 11 This sample size ( n = 75) exceeded the necessary sample size ( n = 45) to detect the expected effect on HDLox based on a standard deviation of 10%. Data were analyzed for normal distribution by the Kolmogorov–Smirnov test.…”

Section: Methodsmentioning

confidence: 94%

The impact of aerobic and isometric exercise on different measures of dysfunctional high-density lipoprotein in patients with hypertension

Pagonas

Vlatsas

Bauer

et al. 2019

Eur J Prev Cardiolog

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Background: Exercise training increases high-density lipoprotein (HDL) cholesterol, but its effect on HDL function is unclear. In hypertensives, exercise improves endothelial dysfunction, which is related to HDL function. In the present study, we assess for the first time the effects of different exercise modalities on two cell-free assays of HDL function. Design: The study was conducted as a prospective randomized controlled trial in 75 hypertensive patients. Methods: Patients were randomized in three groups: (a) handgrip isometric training five times weekly; (b) placebo-handgrip; and (c) aerobic exercise training at least three times per week. HDL function was assessed in serum samples at baseline and after 12 weeks of training by two independent assays that determine the proinflammatory phenotype (haptoglobin content) of a specific amount of HDL (Haptoglobin-HDL [HPHDL]) and oxidized HDL (HDLox) as a measure of reduced antioxidant function of HDL. HDL function measures were normalized by the measures of a pooled control of sera from healthy participants and by HDL-C levels (normalized ratio, no units). Results: Aerobic exercise led to significant reduction of the HDLox from 0.99 ± 0.27 to 0.90 ± 0.29 (no units, p = 0.03). The HPHDL did not change in any training group. Changes of HDLox correlated with reduction of the systolic blood pressure only after aerobic exercise (R = 0.64, p = 0.03). Conclusions: Aerobic but not isometric exercise improves the antioxidant function of HDL in patients with hypertension. This improvement correlates positively with reductions of blood pressure.

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“…Skeletal muscle is the largest insulin-sensitive tissue in the body and is the major site for insulin-stimulated glucose utilization (Stump et al, 2006); thus, loss of muscle mass and muscle quality may play a critical role in the development of CMD (Atlantis et al, 2009;Butcher et al, 2018;Kim and Park, 2018;Li et al, 2018). Although the association between HGS and CMD was found in several studies (Kelley and Kelley, 2010;Peterson et al, 2016Peterson et al, , 2017Karvonen-Gutierrez et al, 2018;Li et al, 2018;Zhang et al, 2018), most studies are cross-sectional design (Dong et al, 2016;Peterson et al, 2016Peterson et al, , 2017Ji et al, 2018;Li et al, 2018;Zhang et al, 2018;Wu et al, 2019) and controversial results exist (Dong et al, 2016;Pagonas et al, 2017;Giglio et al, 2018;Ji et al, 2018). For example, Peterson et al (2017) analyzed the data from the U.S. National Health and Nutrition Examination Survey 2011-2012 and 2013-2014 combined surveys, and the 2011 wave of the China Health and Retirement Longitudinal Study, and found that normalized HGS was robustly associated with both CMD and physical disabilities in the United States and Chinese aging adults.…”

Section: Introductionmentioning

confidence: 99%

The Relative Handgrip Strength and Risk of Cardiometabolic Disorders: A Prospective Study

et al. 2020

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Background: This study aims to investigate the association between handgrip strength (HGS) and cardiometabolic disorders (CMD), including hypertension, diabetes, and dyslipidemia, in a prospective study. Methods: The association between HGS and CMD was examined using the data from 5,271 Chinese adult participants ≥45 years old enrolled in the CHARLS (Chinese Health and Retirement Prospective Cohort Study) during 2011-2015. Relative HGS, calculated as maximal absolute HGS from both hands divided by body mass index, was used in the primary analysis and divided into three groups according to the tertiles (T1, T2, and T3). Results: The participants with higher relative HGS had a lower risk of hypertension, diabetes, and dyslipidemia than those with lower HGS, although did not reach statistical significance for diabetes and hypertension in males. Participants with higher HGS had significantly lower risk of hypertension [T3 vs. T1: OR = 0.69, 95% CI = 0.51-0.91, P = 0.010] and dyslipidemia (OR = 0.65, 95% CI = 0.51-0.83, P < 0.001) in males. For females, participants with higher HGS had significantly lower risks of dyslipidemia (OR = 0.67, 95% CI = 0.54-0.83, P < 0.001). Conclusion: A consistent association was observed between higher relative HGS and lower risk of CMD. Further research is required to evaluate whether relative HGS can be a convincing predictor for the occurrence of CMD and as a target for intervention in the high-risk population.

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Aerobic versus isometric handgrip exercise in hypertension

Abstract: Isometric handgrip training, performed according to a typical protocol, did not reduce BP in hypertensive patients. Aerobic exercise, even as an uncontrolled and unsupervised exercise regimen, led to a significant reduction of ambulatory and office BP.

Cited by 52 publications

References 29 publications

Supervised, but Not Home-Based, Isometric Training Improves Brachial and Central Blood Pressure in Medicated Hypertensive Patients: A Randomized Controlled Trial

Supervised, but Not Home-Based, Isometric Training Improves Brachial and Central Blood Pressure in Medicated Hypertensive Patients: A Randomized Controlled Trial

The impact of aerobic and isometric exercise on different measures of dysfunctional high-density lipoprotein in patients with hypertension

The Relative Handgrip Strength and Risk of Cardiometabolic Disorders: A Prospective Study

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