Isometric handgrip exercise training reduces resting systolic blood pressure but does not interfere with diastolic blood pressure and heart rate variability in hypertensive subjects: a systematic review and meta-analysis of randomized clinical trials

Author(s):  
João Pedro Arantes de Sousa Almeida ◽  
Murilo Bessa ◽  
Leandro Teixeira Paranhos Lopes ◽  
Alexandre Gonçalves ◽  
Leonardo Roever ◽  
...  
2021 ◽  
Author(s):  
Patricia Caetano Oliveira ◽  
Alexandre Machado Lehnen ◽  
Gustavo Waclawovsky

Abstract BackgroundSystemic arterial hypertension (HTN) is the leading risk factor of cardiovascular disease death. Lifestyle changes are key for the prevention and management of HTN. Regular aerobic exercise training is recommended as part of the management of HTN; and dynamic resistance exercise should be prescribed as an adjuvant to aerobic training. Recent evidence points to potential benefits of isometric resistance training in reducing blood pressure (BP). Yet, the hypotensive effect of isometric exercise in pre-hypertensive and hypertensive individuals is not fully understood. Thus, we will examine the effect of isometric exercise in pre-hypertensive and hypertensive individuals through a systematic review and meta-analysis. MethodsOur systematic review study will include randomized clinical trials (RCTs) selected from the electronic databases MEDLINE (PubMed), Cochrane, LILACS, EMBASE and PEDro published in English, Spanish and Portuguese language. We will follow the PRISMA guidelines and PICOS framework. Our search will involve studies with both male and female participants aged 18 years or more diagnosed with prehypertension or HTN performing one session of isometric exercise (acute effect) or isometric exercise training (chronic effect) compared to a control group (no exercise). We will use Cochrane Risk of Bias 2 (RoB 2) tool to evaluate the quality of the studies and RStudio software (v1.3.959 for Windows) for statistical analyses. DiscussionA meta-analysis of a homogeneous sample of pre-hypertensive and hypertensive individuals involving isometric handgrip exercise alone can further support previous findings and improve our understanding and recommendations for the management of these populations. Systematic review registrationThe study protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD 42020213081).


2021 ◽  
Author(s):  
Fatemeh Shirani ◽  
Sahar Foshati ◽  
Mohammad Tavassoly ◽  
Cain C. T. Clark ◽  
Mohammad Hossein Rouhani

2005 ◽  
Vol 288 (4) ◽  
pp. H1724-H1729 ◽  
Author(s):  
Anne Houssiere ◽  
Boutaina Najem ◽  
Agniezka Ciarka ◽  
Sonia Velez-Roa ◽  
Robert Naeije ◽  
...  

To investigate the effects of muscle metaboreceptor activation during hypoxic static exercise, we recorded muscle sympathetic nerve activity (MSNA), heart rate, blood pressure, ventilation, and blood lactate in 13 healthy subjects (22 ± 2 yr) during 3 min of three randomized interventions: isocapnic hypoxia (10% O2) (chemoreflex activation), isometric handgrip exercise in normoxia (metaboreflex activation), and isometric handgrip exercise during isocapnic hypoxia (concomitant metaboreflex and chemoreflex activation). Each intervention was followed by a forearm circulatory arrest to allow persistent metaboreflex activation in the absence of exercise and chemoreflex activation. Handgrip increased blood pressure, MSNA, heart rate, ventilation, and lactate (all P < 0.001). Hypoxia without handgrip increased MSNA, heart rate, and ventilation (all P < 0.001), but it did not change blood pressure and lactate. Handgrip enhanced blood pressure, heart rate, MSNA, and ventilation responses to hypoxia (all P < 0.05). During circulatory arrest after handgrip in hypoxia, heart rate returned promptly to baseline values, whereas ventilation decreased but remained elevated ( P < 0.05). In contrast, MSNA, blood pressure, and lactate returned to baseline values during circulatory arrest after hypoxia without exercise but remained markedly increased after handgrip in hypoxia ( P < 0.05). We conclude that metaboreceptors and chemoreceptors exert differential effects on the cardiorespiratory and sympathetic responses during exercise in hypoxia.


2020 ◽  
Vol 12 (5) ◽  
pp. 470-477 ◽  
Author(s):  
Andrés F. Loaiza-Betancur ◽  
Iván Chulvi-Medrano

Context: High blood pressure is one of the leading preventable causes of cardiovascular death worldwide. In this regard, several studies have shown interest in the benefits of isometric exercise on blood pressure regulation. Objective: To assess whether low-intensity isometric handgrip exercise (LI-IHE) is an effective strategy to lower blood pressure levels in prehypertensive and hypertensive patients. Data Source: This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and registered with PROSPERO. Potentially eligible studies were identified after a systematic search conducted on 4 international databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro, and SPORTDiscus. Study Selection: We included randomized controlled trials that comprised patients who received LI-IHE. Study Design: Systematic review with meta-analysis. Level of Evidence: Level 3. Data Extraction: Data related to patient characteristics, exercise programs, risk-of-bias assessment, and outcomes of interest were systematically reviewed independently by 2 authors. Results: The following reductions (mean differences) were observed after LI-IHE: systolic blood pressure (SBP), (MD) = −5.43 mm Hg; (95% CI, −8.47 to −2.39; P = 0.0005); diastolic blood pressure (DBP), −2.41 mm Hg (95% CI, −4.33 to −0.48; P = 0.01); mean arterial pressure (MAP), −1.28 mm Hg (95% CI, −2.99 to 0.44; P = 0.14). Conclusion: LI-IHE seems to lower SBP, DBP, and MAP values in prehypertensive and hypertensive adults. It appears that LI-IHE reduces, in greater magnitude, blood pressure levels in hypertensive patients, specifically in patients aged <45 years, those who are overweight, and those on medications. Nevertheless, substantial heterogeneity in the main results and in the analyses by subgroups generated uncertainty about the real reduction magnitude that LI-IHE can produce on blood pressure.


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