Blood pressure and cardiac autonomic adaptations to isometric exercise training: A randomized sham‐controlled study

Decaux, Anthony; Edwards, Jamie; Swift, Harry T; Hurst, Philip; Hopkins, Jordan; Wiles, J.; O’Driscoll, Jamie M

doi:10.14814/phy2.15112

Cited by 6 publications

(32 citation statements)

References 37 publications

(56 reference statements)

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“…This study echoes the wider mechanistic literature in that IET predominantly induces reductions in resting BP independent of changes in CO [1,7,8]. Although significant reductions are seen in resting HR, CO remains unchanged as the consequence of a significant increase in SV, which is likely mediated through the significant left ventricular functional and mechanical adaptations recently reported following IET [30].…”

Section: Discussionsupporting

confidence: 81%

“…Using the Bend and Squat device, the home-based wall squat protocol involved participants resting their back against a fixed wall with their feet placed parallel and shoulder width apart, while their arms remained relaxed down by their side (see Supplement File for further details, http://links.lww.com/HJH/C53). Each session involved of 4 x 2-min bouts of isometric wall squat, separated with 2-min rest intervals, with at least 48-h recovery between every session [7–9]. To allow for close monitoring of intensity and adherence, all participants recorded HR and rate of perceived exertion data following each IET bout and uploaded their data to a personal online database, which was monitored by the investigators.…”

Section: Methodsmentioning

confidence: 99%

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One year of isometric exercise training for blood pressure management in men: a prospective randomized controlled study

O’Driscoll

Edwards

Coleman

et al. 2022

Journal of Hypertension

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Objective: Isometric exercise training (IET) over 4-12 weeks is an effective antihypertensive intervention. However, blood pressure (BP) reductions are reversible if exercise is not maintained. No work to date has investigated the long-term effects of IET on resting BP.Methods: We randomized 24 unmedicated patients with high-normal BP to a 1-year wall squat IET intervention or nonintervention control group. Resting BP and various clinically important haemodynamic variables, including heart rate (HR), stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were measured pre and post the 1-year study period.Results: One year of IET produced statistically significant reductions in resting systolic (-8.5 AE 5 mmHg, P < 0.001) and diastolic (-7.3 AE 5.8 mmHg, P < 0.001) BP compared with the control group. There was also a significant reduction in resting HR (-4.2 AE 3.7 b/min, P ¼ 0.009) and a significant increase in SV (11.2 AE 2.8 ml, P ¼ 0.012), with no significant change in CO (0.12 AE 2.8 l/min, P ¼ 0.7). TPR significantly decreased following IET (-246 AE 88 dyneÁs/cm 5 , P ¼ 0.011). Adherence to the IET sessions was 77% across all participants (3x IET sessions per week), with no participant withdrawals. Conclusion:This novel study supports IET as an effective long-term strategy for the management of resting BP, producing clinically important, chronic BP adaptations in patients at risk of hypertension. Importantly, this work also demonstrates impressive long-term adherence rates, further supporting the implementation of IET as a means of effective BP management in clinical populations.

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Section: Discussionsupporting

confidence: 81%

Section: Methodsmentioning

confidence: 99%

One year of isometric exercise training for blood pressure management in men: a prospective randomized controlled study

O’Driscoll

Edwards

Coleman

et al. 2022

Journal of Hypertension

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Section: Discussionmentioning

confidence: 99%

“…Lastly, the greater attention/contact that the intervention groups received may also have contributed to the beneficial trends of IRT, although a previous study which compared wall squat with a sham wall squat (inadequate intensity) only demonstrated BP reductions in the "true" intervention group suggesting that the effects are specific to the exercise itself. 26 While we did not evaluate physiological parameters which might explain the SBP reductions observed, a recent meta-analysis concluded that the principal driver of IRT induced BP reduction is reduced total peripheral resistance, potentially mediated through enhanced autonomic vasomotor control. Changes in cardiovascular function including significantly decreased heart rate and increased stroke volume (with stable cardiac output) are also consistently reported.…”

Section: Blood Pressure Changes-phasementioning

confidence: 97%

Reductions in systolic blood pressure achieved by hypertensives with three isometric training sessions per week are maintained with a single session per week

Cohen

Aroca

Carreño-Robayo

et al. 2023

J of Clinical Hypertension

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Isometric handgrip or (wall) squat exercise performed three times per week produces reductions in systolic blood pressure (SBP) in adults with hypertension. We aimed to compare these interventions and the potential to retain benefits with one exercise session per week. We compared blood pressure changes following handgrip and squat isometric training interventions with controls in a randomized controlled multicentre trial in 77 unmedicated hypertensive (SBP ≥ 130 mmHg) adults. Exercise sessions were performed in the workplace and consisted of four repetitions-three sessions per week for the first 12 weeks (phase 1), and one session per week for the subsequent 12 weeks (phase 2). Office blood pressure (BP) was measured at baseline, post-phase 1 and post-phase 2. Post-phase 1, mean reductions in SBP were significantly greater in handgrip (-11.2 mmHg, n = 28) and squat (-12.9 mmHg, n = 27) groups than in controls (-.4 mmHg; n = 22) but changes in DBP were not. There were no significant within-group changes during phase 2 but SBP was 3.8 mmHg lower in the wall squat than the handgrip group-a small magnitude but clinically important difference.While both interventions produced significant SBP reductions, the wall squat appears to be more effective in maintaining benefits with a minimal training dose. The low time investment to achieve and retain clinically significant SBP reductions-42 and 12 min, respectively-and minimal cost, particularly of the wall squat, make it a promising intervention for delivery in public health settings.

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“…Isometric exercise training (IET) is a highly effective and time‐efficient anti‐hypertensive intervention, with multiple meta‐analyses demonstrating statistically and clinically significant reductions in resting blood pressure (BP) (Edwards et al, 2022; Inder et al, 2016; López‐Valenciano et al, 2019). Fundamentally, these BP reductions have been largely attributed to changes in peripheral vascular resistance, rather than adjustments to central cardiac output (de Caux et al, 2021; Taylor et al, 2019). Despite this, the effects of IET on parameters of arterial stiffness remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

The effect of isometric exercise training on arterial stiffness: A randomized crossover controlled study

Edwards

Jalaludeen

Beqiri

et al. 2023

Physiological Reports

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Isometric exercise training (IET) is an effective intervention for the management of resting blood pressure (BP). However, the effects of IET on arterial stiffness remain largely unknown. Eighteen unmedicated physically inactive participants were recruited. Participants were randomly allocated in a cross‐over design to 4 weeks of home‐based wall squat IET and control period, separated by a 3‐week washout period. Continuous beat‐to‐beat hemodynamics, including early and late systolic (sBP 1 and sBP 2, respectively) and diastolic blood pressure (dBP) were recorded for a period of 5 min and waveforms were extracted and analyzed to acquire the augmentation index (AIx) as a measure of arterial stiffness. sBP 1 (−7.7 ± 12.8 mmHg, p = 0.024), sBP 2 (−5.9 ± 9.9 mmHg, p = 0.042) and dBP (−4.4 ± 7.2 mmHg, p = 0.037) all significantly decreased following IET compared to the control period. Importantly, there was a significant reduction in AIx following IET (−6.6 ± 14.5%, p = 0.02) compared to the control period. There were also adjacent significant reductions in total peripheral resistance (−140.7 ± 65.8 dynes·cm‐5, p = 0.042) and pulse pressure (−3.8 ± 4.2, p = 0.003) compared to the control period. This study demonstrates an improvement in arterial stiffness following a short‐term IET intervention. These findings have important clinical implications regarding cardiovascular risk. Mechanistically, these results suggest that reductions in resting BP following IET are induced via favorable vascular adaptations, although the intricate details of such adaptations are not yet clear.

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Blood pressure and cardiac autonomic adaptations to isometric exercise training: A randomized sham‐controlled study

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 37 publications

One year of isometric exercise training for blood pressure management in men: a prospective randomized controlled study

One year of isometric exercise training for blood pressure management in men: a prospective randomized controlled study

Reductions in systolic blood pressure achieved by hypertensives with three isometric training sessions per week are maintained with a single session per week

The effect of isometric exercise training on arterial stiffness: A randomized crossover controlled study

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