Effects of isometric resistance training on resting blood pressure

Abstract

Background: Previous meta-analyses based on aggregate group-level data report antihypertensive effects of isometric resistance training (IRT). However, individual participant data meta-analyses provide more robust effect size estimates and permit examination of demographic and clinical variables on IRT effectiveness. Methods: We conducted a systematic search and individual participant data (IPD) analysis, using both a one-step and two-step approach, of controlled trials investigating at least 3 weeks of IRT on resting systolic, diastolic and mean arterial blood pressure. Results: Anonymized individual participant data were provided from 12 studies (14 intervention group comparisons) involving 326 participants (52.7% medicated for hypertension); 191 assigned to IRT and 135 controls, 25.2% of participants had diagnosed coronary artery disease. IRT intensity varied (8–30% MVC) and training duration ranged from 3 to 12 weeks. The IPD (one-step) meta-analysis showed a significant treatment effect for the exercise group participants experiencing a reduction in resting SBP of −6.22 mmHg (95% CI −7.75 to −4.68; P < 0.00001); DBP of −2.78 mmHg (95% CI −3.92 to −1.65; P = 0.002); and mean arterial blood pressure (MAP) of −4.12 mmHg (95% CI −5.39 to −2.85; P < 0.00001). The two-step approach yielded similar results for change in SBP −7.35 mmHg (−8.95 to −5.75; P < 0.00001), DBP MD −3.29 mmHg (95% CI −5.12 to −1.46; P = 0.0004) and MAP MD −4.63 mmHg (95% CI −6.18 to −3.09: P < 0.00001). Sub-analysis revealed that neither clinical, medication, nor demographic participant characteristics, or exercise program features, modified the IRT treatment effect. Conclusion: This individual patient analysis confirms a clinically meaningful and statistically significant effect of IRT on resting SBP, DBP and mean arterial blood pressure.

Effect of Isometric Resistance Training on Blood Pressure Values in a Group of Normotensive Participants: A Systematic Review and Meta-analysis

“…22 Previously, systematic reviews reported results from subgroup analyses that described significant reductions in SBP, DBP, and MAP in participants classified as normotensive by the guidelines at that time. 2,9,10,13,20 Nevertheless, our results show lower magnitudes of BP reductions than those previously reported. 2,4,9,10,13,20 This could be specifically due to the strong association reported that IRT generates reductions of greater magnitude in medicated hypertensive patients.…”

“…21 However, the body of evidence on the effects of isometric resistance training (IRT) in normotensive, prehypertensive, and hypertensive individuals is growing. 2,4,9,10,13,20 Thus, a systematic review and meta-analysis that included randomized controlled trials in which IRT was performed in normal and hypertensive adults concluded that this form of training has the potential to significantly reduce BP and suggested it as a complementary treatment method. 9 In general, this meta-analysis reported a significant reduction in SBP, DBP, and mean arterial BP (MAP) (-5.20, -3.91, and -3.33 mm Hg, respectively).…”

“…2,4,9,10,13,20 Nevertheless, there is still uncertainty about the reductions generated by IRT on SBP, DBP, and MAP due to the heterogeneity of the results reported by these studies. 2,4,9,10,13,20 Particularly, in the preliminary searches, we did not find systematic reviews and meta-analyses that reported, in their main analysis, on the effects of IRT on BP values of normotensive participants with current recommendations from the American Heart Association and the American College of Cardiology. 22 Therefore, the aim of this systematic review and meta-analysis was to quantify the effect of IRT on SBP, DBP, and MAP values in normotensive adult participants.…”

Exercise, Cardiovascular Health, and Risk Factors for Atherosclerosis: A Narrative Review on These Complex Relationships and Caveats of Literature

“…More recently, motivated by the previously observed potential effect of IRT ( Cornelissen and Smart, 2013 ), a new meta-analysis using the “individual patient data” approach ( Smart et al, 2019 ) examined the effects of this intervention in BP values. Using a robust methodology, the authors evaluated 12 trials, with 14 intervention groups, totaling 326 patients (191 enrolled in IRT and 135 in control), analyzed at the individual level.…”

Effects of isometric handgrip training on cardiac autonomic profile: A systematic review and meta‐analysis study

“…Handgrip has been the most studied form of isometric training. It has shown to reduce systolic blood pressure (SBP) by 5–8 mm Hg and diastolic blood pressure (DBP) by approximately 2–4 mm Hg in both normotensive and hypertensive individuals (Bentley, Nguyen, & Thomas, ; Lopez‐Valenciano, Ruiz‐Pérez, Ayala, Sánchez‐Meca, & Vera‐Garcia, ; Smart et al, ). This evidence supports the use of isometric handgrip training as an adjunct treatment to reduce blood pressure in hypertensive patients (Brook et al, ).…”