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Wehrmann A, Tian EJ, Tyack EL, Kumar S. The evidence of effectiveness of isometric resistance training on the management of hypertension in adults: an umbrella review. Blood Press Monit 2023; 28:171-184. [PMID: 37318780 DOI: 10.1097/mbp.0000000000000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Hypertension is the leading risk factor for cardiovascular disease yet also one of the most readily preventable causes of death. Isometric resistance training (IRT) has gained increasing popularity in recent times as a viable nonpharmacological management option for hypertension. Whilst there have been several reviews on this topic, with varying findings, this umbrella review aimed to summarize the current evidence underpinning the effectiveness of IRT for hypertension. Quantitative systematic reviews and meta-analyses published in English were considered for inclusion. Commercially produced and grey literature was searched between December 2021 and January 2022. Methodological quality of included reviews was determined using the AMSTAR 2 critical appraisal tool. Customized data extraction tools were developed for this review and data were synthesized using the National Health and Medical Research Council FORM Framework. Twelve reviews published between 2011 and 2021 of varying methodological quality were identified. Isometric handgrip exercise training with four sets of 2-min contractions and 1 min rest period between each set was the most utilized intervention, undertaken three times per week for at least 8 weeks. Collectively, there is consistent evidence to indicate IRT has positive impacts on SBP and DBP as well as mean arterial pressure. These positive impacts were reported for normotensive as well as hypertensive individuals. Given IRT is a readily available, easy-to-use intervention with minimal financial cost, it could be considered a viable treatment option for people with, and at risk of, hypertension.
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Affiliation(s)
- Abbey Wehrmann
- UniSA Allied Health and Human Performance, UniSA Allied Health and Human Performance, University of South Australia, Adelaide
| | - Esther J Tian
- UniSA Allied Health and Human Performance, UniSA Allied Health and Human Performance, University of South Australia, Adelaide
| | - Elizabeth Liz Tyack
- Brain Injury Rehabilitation Community and Home (BIRCH) NORTH, SA Brain Injury Rehabilitation Services (SABIRS), Brain Injury Rehabilitation Community and Home (BIRCH) NORTH, SA Brain Injury Rehabilitation Services (SABIRS), Central Adelaide Local Health Network - SA Health, Hampstead Rehabilitation Centre, Lightsview
- Brain Injury Rehabilitation Community and Home (BIRCH) SOUTH, SA Brain Injury Rehabilitation Services (SABIRS), Brain Injury Rehabilitation Community and Home (BIRCH) SOUTH, SA Brain Injury Rehabilitation Services (SABIRS), Central Adelaide Local Health Network - SA Health, Repat Health Precinct, South Australia, Australia
| | - Saravana Kumar
- UniSA Allied Health and Human Performance, UniSA Allied Health and Human Performance, University of South Australia, Adelaide
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Wen Y, Liu T, Ma C, Fang J, Zhao Z, Luo M, Xia Y, Zhao Y, Ji C. Association between handgrip strength and metabolic syndrome: A meta-analysis and systematic review. Front Nutr 2022; 9:996645. [PMID: 36532558 PMCID: PMC9751936 DOI: 10.3389/fnut.2022.996645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/14/2022] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Although muscle strength has been reported to be associated with metabolic syndrome (MetS), the association is still controversial. Therefore, the purpose of this meta-analysis was to identify the association between handgrip strength (HGS) and MetS. METHODS Original research studies involving HGS and MetS from database inception to 20 May 2022 were selected from PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang databases, and Chinese Biomedical Document Service System. The odds ratios (ORs) with 95% confidence intervals (CIs) of MetS for HGS were calculated using a random-effects model. A dose-response analysis was performed. Subgroup analysis and meta-regression were also conducted. RESULTS Thirty effect sizes (reported in 19 articles) with a total of 43,396 participants were included in this meta-analysis. All studies were considered to be of moderate-to-good quality. An inverse association between HGS (low vs. high) with MetS was shown (OR: 2.59, 95% CI: 2.06-3.25). Subgroup analyses demonstrated the pooled ORs of relative HGS (HGS/weight), relative HGS (HGS/BMI), and absolute HGS were 2.97 (95% CI: 2.37-3.71), 2.47 (95% CI: 1.08-5.63), and 1.34 (95% CI: 1.06-1.68), respectively. Dose-response analysis revealed a significant linear dose-response relationship between relative HGS (HGS/weight) and MetS in observational studies (0.1 HGS/weight: OR, 0.68; 95% CI: 0.62-0.75). Univariate meta-regression analysis indicated that country status, measuring tools of HGS, components of MetS, and diagnosed criteria of MetS explained 16.7%, 26.2%, 30.1%, and 42.3% of the tau-squared in the meta-regression, respectively. CONCLUSION The results of the current meta-analysis indicated that lower HGS is associated with a higher risk of MetS. A linear dose-response association between lower relative HGS (HGS/weight) and increased prevalence of MetS was found. Accordingly, a lower HGS is a significant predictor of MetS. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021276730].
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Affiliation(s)
- Yu Wen
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tiancong Liu
- Department of Otorhinolaryngology - Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Changcheng Ma
- Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jianwei Fang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiying Zhao
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mengrui Luo
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chao Ji
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, Liaoning, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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Zhang B, Wang X, Gu Y, Zhang Q, Liu L, Meng G, Wu H, Zhang S, Zhang T, Li H, Zhang J, Sun S, Wang X, Zhou M, Jia Q, Song K, Huang J, Huo J, Zhang B, Ding G, Niu K. The association between grip strength and incident carotid atherosclerosis in middle-aged and older adults: The TCLSIH cohort study. Maturitas 2022; 167:53-59. [DOI: 10.1016/j.maturitas.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/03/2022] [Accepted: 09/17/2022] [Indexed: 10/14/2022]
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Yamada Y, Spitz RW, Wong V, Bell ZW, Song JS, Abe T, Loenneke JP. The impact of isometric handgrip exercise and training on health‐related factors: A review. Clin Physiol Funct Imaging 2022; 42:57-87. [DOI: 10.1111/cpf.12741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/10/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Yujiro Yamada
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Robert W. Spitz
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Vickie Wong
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Zachary W. Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Jun Seob Song
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
| | - Takashi Abe
- Graduate School of Health and Sports Science Juntendo University Inzai Chiba Japan
| | - Jeremy P. Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management The University of Mississippi Oxford Mississippi USA
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Ji C, Xia Y, Tong S, Wu Q, Zhao Y. Association of handgrip strength with the prevalence of metabolic syndrome in US adults: the national health and nutrition examination survey. Aging (Albany NY) 2020; 12:7818-7829. [PMID: 32365052 PMCID: PMC7244054 DOI: 10.18632/aging.103097] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/30/2020] [Indexed: 04/08/2023]
Abstract
OBJECTIVE Aimed to find the cut-off point of handgrip strength and it's association with MetS. RESULTS The relative handgrip strength was negatively associated with the prevalence of MetS. Of note, the odds ratios (ORs) with 95% confidence intervals (CIs) across tertiles of relative handgrip strength were 1 (reference), 0.45 (0.33, 0.62), and 0.13 (0.08, 0.20) in male participants after adjusting for demographic factors, calorie intake, and physical activity. Similar results were observed in female participants. The cutoff values of relative handgrip strength for male and female participants were 0.52 and 0.40, respectively. CONCLUSIONS Findings of this study suggest that a strong relationship exists between handgrip strength and prevalence of MetS in US adults, regardless of sex. METHODS A total of 5 056 participants in the National Health and Nutrition Examination Survey were analysed in this study. Handgrip strength was measured by using a handgrip dynamometer. MetS was defined in accordance with the criteria of the scientific statement of the American Heart Association in 2009. Multivariable binary logistic regression was used to explore the association between handgrip strength and MetS.
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Affiliation(s)
- Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shuhui Tong
- Drilling and Production Technology Research Institute of Petrochina Liaohe Oilfield Company, Panjin, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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Baddeley-White DS, McGowan CL, Howden R, Gordon BDH, Kyberd P, Swaine IL. Blood pressure lowering effects of a novel isometric exercise device following a 4-week isometric handgrip intervention. Open Access J Sports Med 2019; 10:89-98. [PMID: 31417322 PMCID: PMC6600323 DOI: 10.2147/oajsm.s193008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Hypertension is the leading risk factor for global mortality. Isometric resistance exercise training reduces blood pressure (BP). However, the protocols used are often limited by cost/immobility and the use of rigid exercise modalities. In response, a novel more versatile, isometric exercise (IE) device, the IsoBall (IB) was created. Purpose: The aim of this study was to test the BP-lowering effectiveness of this prototype. Methods: Twenty-three healthy participants (29.10±2.19 years old, 173.95±3.83 cm, 75.43±5.06 kg, SBP 127.10±10.37 mmHg, DBP 70.40±6.77 mmHg) were randomly allocated to either a control group (CON) or 2 isometric handgrip (IHG) training groups that used the Zona plus (ZON) and IB devices. The intervention groups completed 3 sessions each week of 4, 2 min IHG at 30% maximal voluntary contraction, with a 1-min rest, for 4 weeks. Resting BP, heart rate (HR) and IHG strength were measured in all groups at baseline and postintervention. Results: Postintervention systolic BP (SBP) was significantly lower in both ZON (114.5±8.2 mmHg, p = 0.000) and IB (119.9±7.0 mmHg, p = 0.000) compared to control (131.0±12.4 mmHg). Postintervention diastolic BP (DBP) was reduced in both intervention groups (ZON 66.6±7.4 mmHg, p = 0.004; IB 65.7±10.0 mmHg, p = 0.012) compared to CON (71.1±8.8 mmHg). Mean arterial pressure (MAP) was reduced in both groups (ZON 82.6±6.8 mmHg, p = 0.000; IB 84.3±9.1 mmHg, p = 0.000) compared to control (91.0±9.7 mmHg). No significant changes were seen in HR or strength (p > 0.05). Conclusion: The results of this study indicate that both the ZON and IB devices elicit significant SBP, DBP and MAP reductions. Despite the ZON group having larger reductions in BP, no significant differences were found between the two devices. Thus, this study indicates the IB device to be an effective alternative to the ZON that can also be used to perform other IE modalities.
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Affiliation(s)
| | - Cheri L McGowan
- Department of Kinesiology, Faculty of Human Kinetics, University of Windsor, Windsor, ON, Canada
| | - Reuben Howden
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Benjamin DH Gordon
- Department of Exercise and Rehabilitative Sciences, Slippery Rock University, Slippery Rock, PA, USA
| | - Peter Kyberd
- Department of Engineering Science, University of Greenwich, Medway Campus, London, UK
| | - Ian L Swaine
- Department of Life & Sport Sciences, University of Greenwich, Medway Campus, London, UK
- Department of Kinesiology, Faculty of Human Kinetics, University of Windsor, Windsor, ON, Canada
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Wu H, Liu M, Chi VTQ, Wang J, Zhang Q, Liu L, Meng G, Yao Z, Bao X, Gu Y, Zhang S, Sun S, Zhou M, Jia Q, Song K, Huang J, Huo J, Zhang B, Ding G, Niu K. Handgrip strength is inversely associated with metabolic syndrome and its separate components in middle aged and older adults: a large-scale population-based study. Metabolism 2019; 93:61-67. [PMID: 30690038 DOI: 10.1016/j.metabol.2019.01.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/19/2019] [Accepted: 01/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Muscle weakness is followed by insulin resistance which is associated with metabolic disorders leading to metabolic syndrome (MetS). Therefore, muscle strength decline may be associated with MetS. The aim of this study was to investigate the relationships between muscle strength and MetS and its separate components. METHODS A cross-sectional study was performed in 17,703 participants aged 40 years and older living in Tianjin, China. Handgrip strength was measured using a handheld digital dynamometer. MetS was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. Multiple logistic regression analyses were used to assess the association between handgrip strength and MetS and its separate components. RESULTS The overall prevalence of MetS was 33.6%. The prevalence of MetS was significantly higher in men than in women (41.6% vs 22.9%, P < 0.0001). After adjustment for potential confounding factors (including sociodemographic variables, lifestyle factors, total energy intake, and family history of disease), the odds ratios (95% confidence interval) of MetS across decreasing handgrip strength quartiles were: 1.00 (reference), 1.87 (1.66, 2.11), 2.40 (2.13, 2.71), and 3.36 (2.97, 3.80) in men and 1.00 (reference), 1.80 (1.48, 2.21), 2.77 (2.29, 3.36), and 3.89 (3.22, 4.71) in women, respectively (P for all trend <0.0001). Similarly, handgrip strength was also observed to be negatively associated with separate components of MetS both in men and women. CONCLUSIONS Muscle strength is inversely associated with MetS and its separate components. Further prospective studies are needed to confirm this issue.
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Affiliation(s)
- Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health; Center for International Collaborative Research on Environment, Nutrition and Public Health
| | - Mingyue Liu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Vu Thi Quynh Chi
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jing Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health, Beijing, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health; Center for International Collaborative Research on Environment, Nutrition and Public Health
| | - Zhanxin Yao
- Tianjin Institute of Environmental & Operational Medicine, Tianjin, China
| | - Xue Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Jian Huang
- Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health, Beijing, China
| | - Junsheng Huo
- Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health, Beijing, China
| | - Bing Zhang
- Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health, Beijing, China
| | - Gangqiang Ding
- Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health, Beijing, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health; Center for International Collaborative Research on Environment, Nutrition and Public Health.
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Bentley DC, Nguyen CH, Thomas SG. Resting blood pressure reductions following handgrip exercise training and the impact of age and sex: a systematic review and narrative synthesis. Syst Rev 2018; 7:229. [PMID: 30541603 PMCID: PMC6292032 DOI: 10.1186/s13643-018-0876-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The risk of developing cardiovascular disease can be directly correlated to one's resting blood pressure (BP), age, and biological sex. Resting BP may be successfully reduced using handgrip exercise training, although the impact of age and sex on training effectiveness has yet to be systematically evaluated. The objective of this systematic review is to determine this impact of age and sex on handgrip-induced changes to resting BP. METHODS Data sources included MEDLINE, Embase, Cochrane Reviews, CINAHL, SPORTDiscus, Web of Science, AMED, PubMed, and Scopus through May 2018. Eligibility criteria were those with prospective handgrip exercise training of ≥ 4 weeks with reported impact on resting systolic BP (SBP). Screening of articles, data extraction, and quality appraisal were completed in duplicate. When necessary, the corresponding authors were contacted to provide segregated data based on age (younger, 18-54 years; aged, > 55 years) and sex (men, women) categories. SBP was primarily explored with numerous secondary outcomes of interest summarized as a narrative synthesis. RESULTS After screening 1789 articles, 26 full texts were reviewed. Eight studies reported data in a way that facilitated age and sex comparisons of primary outcomes, while 7 of 18 studies reporting pooled data (men and women) provided segregated results. Research spans 1992-2018 and represents 466 participants; at least 43.1% of whom are women. Although weighted mean differences reveal that handgrip training-induced SBP reductions are similar when merely comparing sexes (women; - 5.6 mmHg, men; - 4.4 mmHg) or ages (younger; - 5.7 mmHg, aged; - 4.4 mmHg), when the impact of sex and age is simultaneously evaluated, aged women experience the largest reduction in SBP (- 6.5 mmHg). Many factors were explored for their impact on resting BP reductions and have been summarized in the corresponding narrative synthesis. CONCLUSIONS Handgrip exercise is an effective modality for resting BP reduction resulting in clinically significant reductions for men and women of all ages. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015019792.
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Affiliation(s)
| | - Cindy H Nguyen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Scott G Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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