Twenty weeks of isometric handgrip home training to lower blood pressure in hypertensive older adults: a study protocol for a randomized controlled trial

Effect of a home-based isometric handgrip training programme on systolic blood pressure in adults: A randomised assessor-blinded trial

OBJECTIVES

To evaluate the effects of 20 weeks of home-based isometric handgrip training (IHT) compared with usual care on systolic blood pressure (SBP) in adults.

DESIGN AND PARTICIPANTS

This was a randomised, controlled, assessor-blinded trial. Participants were randomised to either IHT (intervention group) or usual care (control group).

INTERVENTIONS

Participants randomised to the intervention group performed a session of 16 min of effective workout home-based IHT three times per week for 20 weeks. Participants randomised to the control group were asked to continue their daily activities as usual.

OUTCOMES

The primary outcome was the difference in SBP between groups over 20 weeks. Secondary outcomes were diastolic blood pressure, heart rate, handgrip strength, and self-administered home blood pressure measures.

RESULTS

Forty-eight adults (mean [SD] age, 64 [8] years) were included in this trial. The adjusted between-group mean difference in SBP was 8.12 mmHg (95% CI 0.24 to 16.01, p = 0.04) - favouring the usual care group. No differences between groups were found in any of the home blood pressure measurements.

CONCLUSIONS

This trial showed that 20 weeks of home-based isometric handgrip training was not superior compared to the usual care in lowering SBP.

The effectiveness and safety of isometric resistance training for adults with high blood pressure: a systematic review and meta-analysis

High blood pressure (BP) is a global health challenge. Isometric resistance training (IRT) has demonstrated antihypertensive effects, but safety data are not available, thereby limiting its recommendation for clinical use. We conducted a systematic review of randomized controlled trials comparing IRT to controls in adults with elevated BP (systolic ≥130 mmHg/diastolic ≥85 mmHg). This review provides an update to office BP estimations and is the first to investigate 24-h ambulatory BP, central BP, and safety. Data were analyzed using a random-effects meta-analysis. We assessed the risk of bias with the Cochrane risk of bias tool and the quality of evidence with GRADE. Twenty-four trials were included (n = 1143; age = 56 ± 9 years, 56% female). IRT resulted in clinically meaningful reductions in office systolic (-6.97 mmHg, 95% CI -8.77 to -5.18, p < 0.0001) and office diastolic BP (-3.86 mmHg, 95% CI -5.31 to -2.41, p < 0.0001). Novel findings included reductions in central systolic (-7.48 mmHg, 95% CI -14.89 to -0.07, p = 0.035), central diastolic (-3.75 mmHg, 95% CI -6.38 to -1.12, p = 0.005), and 24-h diastolic (-2.39 mmHg, 95% CI -4.28 to -0.40, p = 0.02) but not 24-h systolic BP (-2.77 mmHg, 95% CI -6.80 to 1.25, p = 0.18). These results are very low/low certainty with high heterogeneity. There was no significant increase in the risk of IRT, risk ratio (1.12, 95% CI 0.47 to 2.68, p = 0.8), or the risk difference (1.02, 95% CI 1.00 to 1.03, p = 0.13). This means that there is one adverse event per 38,444 bouts of IRT. IRT appears safe and may cause clinically relevant reductions in BP (office, central BP, and 24-h diastolic). High-quality trials are required to improve confidence in these findings. PROSPERO (CRD42020201888); OSF ( https://doi.org/10.17605/OSF.IO/H58BZ ).

Home-based isometric handgrip training on RBP in hypertensive adults-Partial preliminary findings from RCT

OBJECTIVE

The aim of this study is to confirm whether 8 weeks of home-based isometric handgrip (IHG) training would reduce resting blood pressure (RBP) in an adult Indian population.

METHODOLOGY

Hypertensive patients (Stage 1 [previously prehypertension] and Stage 2 [previously Stage 1 hypertension]) aged 30-45 years, male and female, were included.

INTERVENTION

Two groups were included (active control group and IHG training group at 30% of maximal voluntary isometric contraction). Outcomes of this study were resting pulse rate (PR) and RBP, which were taken at baseline and after 8 weeks. Stratified randomization was done by sex and hypertension grade. The study was a double-blind intervention (both participants and the assessor were blinded to intervention allotment).

RESULTS

Forty hypertensive individuals were randomly assigned to a control (N = 20) and an 8-week home-based IHG training (N = 20) using a stratified random sampling technique. Each training session consisted of 4 × 2 min bouts with a 4-min rest between bouts for 8 weeks. Resting PR and RBP were taken at baseline and after 8 weeks. After 8 weeks, there was a significant reduction in blood pressure and PR values in the IHG group as compared with those in the control group: systolic blood pressure (mean difference, MD -8.75 mmHg; 95% CI [-6.51, -10.39]); diastolic blood pressure (MD -8.35 mmHg; 95% CI [-6.25, -10.45]); mean arterial pressure (MD -8.13 mmHg; 95% CI [-6.21, -10.05]); and PR (MD -8.90 mmHg; 95% CI [-5.08, -12.72].

CONCLUSION

On the basis of study findings, home-based IHG training can be used as an adjunct to control BP in the initial stage of hypertension in an Indian population.